THOUGHT FOR THE DAY...

Darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate; only love can do that.

Statins Slow Prostate Growth

Cholesterol-lowering statin drugs may slow prostate growth in men who have elevated PSA levels, according to a new analysis. The research, led by Duke University Medical Center, suggests statins may have beneficial effects on prostate health and provide a new way to treat men with enlarged prostates. Previous studies have linked statins to lower levels of PSA – prostate specific antigen, a protein often elevated by prostate cancer or other prostatic diseases. The new study, presented at the annual meeting of the American Urological Association, found the rate of prostate growth diminished among men with elevated PSA levels who took statins. Enlarged prostate, also known as benign prostate hyperplasia, causes urinary problems and can lead to bladder and kidney damage. Up to 90 percent of men over the age of 70 experience the condition, according to the National Institutes of Health. "Given that prostate enlargement is an important health problem in the United States and elsewhere, and will be a larger problem as the population ages, it's important to understand and treat its causes," said lead researcher Dr. Roberto Muller. Muller and colleagues tracked the health records of more than 6,000 men, including 1,032 who took statins. They found the prostate sizes were similar between statin users and non-users at the start of the study, but within two years those who took cholesterol-lowering drugs had less prostate growth. "We don't yet understand the mechanisms that might be causing this," Muller said. "Some have suggested that statins may have anti-inflammatory properties, and inflammation has been linked to prostate growth, but this needs further study." Muller said the findings also suggest that lifestyle choices such diet and exercise may not only affect cholesterol, but also prostate health.

What Irregular Bowel Movements Are Telling You Pebbled, Painful or Light-Colored Bowel Movements? Learn What it Means

To 3-year-olds, bowel movements are an exciting feat. To grown-ups, they're a picture of how our bodies are working. Find out what irregular bowel movements mean, and what certain changes in color, texture and frequency say about our health. Most of us just flush and forget it. But bowel movements can reveal whether we’re eating right, staying hydrated and maintaining our systems. “Daily attention can tell you whether you eat enough fiber or have health problems like cancer or inflammatory bowel disease [a group of conditions such as colitis and Crohn’s disease that inflame the colon and small intestine],” says gastroenterologist Anish A. Sheth, M.D., assistant professor of medicine at Yale University School of Medicine in New Haven, Conn., and author of What’s Your Poo Telling You (Chronicle Books). What you’re looking for are changes in look, color and smell, Sheth says. This simple step can help you identify health issues sooner than you would have otherwise. It’s normal to have anywhere from three bowel movements a day to three a week. (Any fewer and you’re skirting constipation, according to the National Institute of Digestive Diseases). So you have plenty of chances to keep an eye out for the following issues. 1. Pebble-like stool What it means: You’re not getting enough fiber in your diet, so your bowel movements won’t clump in larger lumps. “The recommended daily amount of fiber is 25-35 grams a day. That will take care of pebble poo,” Sheth says. Reaching that amount is easier than you think: Eat a cup of raspberries and a half-cup of lentils (8 grams each); a half-cup of cooked greens (4 grams) and a cup of whole-wheat pasta (6 grams). Small poo clumps could also mean you’re not drinking enough fluids, says Mariam Fayek, M.D., a gastroenterologist at the Center for Women’s Gastrointestinal Services, Women and Infants Hospital in Providence, R.I. “Women have long colons, so the waste has a longer transit time," she says. "And the longer it’s in the colon, the harder [and drier] it gets.” Drink at least six 8-ounce glasses of water a day if you suspect that’s the issue. When to worry: By itself, pebbly poo isn’t worrisome, says Sheth. But if you also feel that you’re not emptying your bowels completely, something could be wrong with your rectum. For example, pregnant women’s pelvic-floor muscles weaken, which can cause an internally herniated, or protruding, rectum. Waste can get stuck in the pocket the hernia creates, exiting only in pebbles, says Fayek. Pelvic-floor exercises can help, or this may need to be repaired with surgery. 2. Leaky stool What it means: Runny stools can signal several issues: infection, virus, intolerance (to lactose-rich dairy foods, for example) or a gastrointestinal condition like colitis (inflammation of the colon) or Crohn’s disease, a chronic inflammatory condition of the intestinal tract. It’s more common after childbirth or as we get older, says Sheth. “During childbirth, women may experience small tears in the sphincter muscles that keep stool inside. As these muscles weaken with age, in the 40s and beyond, women may have more [leakage].” You can strengthen the muscles around the rectum by practicing tightening them. That’s usually done in a biofeedback program, says Sheth, a process during which a machine monitors changes in the body, like muscle tension. Lack of fiber could also be a factor. You may need more roughage to bulk up your poo, says Kevin Dolehide, M.D., a gastroenterologist at Advocate South Suburban Hospital in Hazel Crest, Ill., and assistant professor of medicine at Midwestern University in Downer’s Grove, Ill. When to worry: If you know it’s the flu, stay well hydrated, says Dolehide. If not, and it lasts more than a day, see your doctor to determine the cause. 3. Black or red poo What it means: Certain medicines – such as Pepto Bismol and iron supplements – can turn poo black. Red in the stools may be the calling card from beets or tomato sauce. If blood is causing the color, it could mean hemorrhoids, rectal bleeding or even cancer. When to worry: Blood is always a concern and requires a doctor’s visit. If stools are black and you’re not taking iron or Pepto-Bismol, “you need to rule out gastrointestinal bleeding,” Dolehide says. This would show up as black, tarry and foul-smelling stools, according to Sheth. Read the next entry for more on these warning signs. 4. Constant Wiping What it means: Sticky, gel-like stools could be a sign of gastrointestinal bleeding, especially if it’s dark and has been happening for only a short time, says Sheth. Large hemorrhoids – enlarged blood vessels in the rectal area – can also make it hard to clean after a bowel movement. When to worry: If the signs point to gastrointestinal bleeding, see a doctor as soon as possible. If not, you should still see a doctor to confirm whether you have hemorrhoids and to rule out other conditions, such as cancer. If you’re over age 50, your doctor may schedule a colonoscopy – a visual exam of the colon with a colonscope – to be sure, says Sheth. 5. Loose stools What it means: Diarrhea can result from too much sugarless gum or soda. “The artificial sweetener sorbitol and fructose [a sweetener] used in sodas [act as a laxative]," Fayek says. "They pull water into the colon because they can’t be absorbed, which makes bowel movements loose." Cutting down on those habits and bulking up your stool with fiber supplements such as Benefiber or Citrusol will help. And watch your diet: If diarrhea always happens after you eat dairy food, you could have lactose intolerance, an inability to digest milk products. If the cause seems unclear, recurring diarrhea could indicate an infection, inflammatory bowel disease (IBD) or celiac disease (caused by intolerance of gluten, an ingredient in wheat). When to worry: If you’re losing weight, have a family history of IBD, find blood in your stool or have just returned from a foreign country, make an appointment. These all point to the more serious conditions mentioned above. 6. It hurts to go What it means: If you’re straining like a heavyweight on the toilet, you’re probably constipated – and your efforts may have caused hemorrhoids or tears in your sphincter muscle, says Sheth. Soothe yourself with over-the-counter remedies like Preparation H or an acetaminophen (Atasol) suppository, says Dolehide. A stool softener like docusate sodium (Colace) or polyethylene glycol (Miralax) will make stools easier to pass. When to worry: If the over-the-counter treatments above don’t resolve the problem within two weeks, and you have ongoing pain, call the doctor. Large tears may require surgery to repair. 7. Constipation What it means: You’re eating too many hamburgers and fries. The typical Western diet doesn’t give us enough fiber, says Fayek. Constipation can also be caused by medications, like those for high blood pressure. As with pebble poo, eating 35 grams of fiber a day – lots of beans, fruits, vegetables and whole grains – and drinking enough water can ease constipation, according to Sheth. Regular exercise aids regularity too. And go when you have the urge: The longer you wait, the drier the stool becomes, and the tougher it is to pass. When to worry: If constipation doesn’t get better for several weeks, causes pain or is accompanied by other changes such as bleeding, see your doctor, says Sheth – especially if you’re around 50 and haven’t yet had a colonoscopy. 8. Light-colored stool What it means: Stools get their color from bile (fluid secreted by the liver), so a light gray or tan poo could mean an obstruction, like a stone, in your bile duct, says Dolehide. More seriously, it could indicate pancreatic cancer or a liver disorder. When to worry: One day of light-colored poo isn’t a problem. That could just be a shift in bacteria, says Fayek. But if it continues, see your doctor to rule out other health conditions. 9. Greenish-yellow stool What it means: “If you’ve eaten a can of spinach or green Jell-O, that’s probably enough explanation,” Sheth says. But if it’s happening consistently and you’re going to the bathroom more often, “green-goblin poo is a classic symptom of infection,” Sheth says. “And there’s a particular kind of colitis that causes seaweed-green poo.” When to worry: Isolated incidents? Stay calm. But if the green continues, see a doctor. If colitis is the culprit, you’ll probably also have fever, cramping and diarrhea. 10. Pencil-thin stool What it means: Again, not enough fiber is the likely cause. But if it lasts over weeks or months, it could mean rectal cancer, which narrows the rectal opening, says Sheth. When to worry: If you’re eating enough fiber and the stool is still thin, see your doctor to rule out cancer. 11. Extra-smelly stool What it means: The normal odor of excrement comes from mercaptans, sulfur-containing compounds. Brussels sprouts, onions and red wine produce more of them, says Sheth. But if it’s unusually foul – that could signal conditions like gastrointestinal bleeding or trouble digesting fat, possibly from other problems. “Fat makes its way into the stool and causes a terrible aroma," Sheth says. "People with pancreatic or liver problems can’t digest fat appropriately.” When to worry: If your poo smells worse than usual and it can’t be traced back to dietary changes, see your doctor. 12. Mucousy Stool What it means: “Most of time, I see [this sort of stools] in young women with irritable bowel syndrome,” Fayek says. This gastrointestinal disorder, which can cause pain, diarrhea and/or or constipation, is most common in young women and at least twice as likely in females than in men. It could also be a sign of inflammatory bowel or celiac diseases. When to worry: If it happens all the time, and you’re losing weight, have rectal bleeding or abdominal pain, or you have a family history of inflammatory bowel disease or celiac, see your doctor, says Fayek.

Nutrition and Exercise 10 Ways to Lower Your Cholesterol Naturally

What’s the nation’s No. 1 killer of women? Heart disease. It causes one death every 35 seconds. Janet Bond Brill, a registered dietitian and author of Cholesterol Down, says you can reduce the bad stuff, without the help of pills. She shares 8 super-foods to eat. Plus, how much do you know about heart health? Cholesterol and Heart Disease In the annual physical, your doctor checks your cholesterol levels. But what is it? And what do the numbers say about your health? Cholesterol is a type of lipid or fat. In our bodies, it travels through our blood stream in particles called lipoproteins. Low-density lipoproteins (LDL) are bad because they can lead to a buildup of plaque in arteries. A mass of plaque can narrow your arteries and restrict blood flow – much like trying to sip juice through a clogged straw. Eventually, the plaque ruptures and a blood clot forms, cutting off the flow of blood, oxygen and nutrients to the brain. Hello, heart attack and stroke! High-density lipoproteins (HDL), on the other hand, are good because they pick up the LDL clogging your arteries and take it to the liver, where it’s processed and eventually excreted. A total blood cholesterol level of 200 and above is cause for concern, especially if you have type 2 diabetes, according to the American Heart Association. Chow Down “Lowering your cholesterol reduces your risk of contracting heart disease and dying from a heart attack,” Brill says. What you eat can affect the amounts of HDL and LDL flowing through your bloodstream, and Brill has a cholesterol-lowering eating plan that’s tasty and effective. “My diet is about what you can eat – not what you can’t,” she says. What’s on her list? Try these 8 super-foods to reduce diabetic hyperlipidemia. Aim to eat all eight daily and heed the two bonus tips as well: 1. Oatmeal Oats are rich in beta-glucan, a soluble fiber that acts like a sponge to soak up cholesterol. How to sneak it in: Add cinnamon or dried cranberries to your morning oatmeal for a flavor boost. Oat-bran is a highly concentrated source of beta-glucan and it’s easy to mix into homemade bread, muffin and pancake batter. Check out these Oatmeal Chocolate Chip Cookies. Brill’s daily Rx: 3 grams of beta-glucan, found in a half cup of dry oatmeal or oat bran. 2. Almonds Almonds contain two powerful antioxidants – vitamin E and flavonoids – which prevent the oxidation of LDL, a precursor to plaque buildup. How to sneak it in: Eat almonds with their skins, which pack a hefty dose of flavonoids. Stir a handful into yogurt or spread two tablespoons of almond butter on whole-wheat bread. Make these Spiced Spanish Almonds for a snack. Brill’s daily Rx: One ounce of dry-roasted, unsalted almonds. 3. Flaxseeds Flaxseeds contain lignan and soluble fiber, which block the production of LDL and increase your body’s ability to get rid of cholesterol. How to sneak it in: Eat ground flaxseeds rather than whole ones, because your body can better absorb its nutrients. Brill likes to sprinkle them into her morning oatmeal. New studies also show that whole flaxseeds are better than flaxseed oil for lowering cholesterol. Use whole flaxseed in these Blueberry-Maple Muffins. Brill’s daily Rx: 2 tablespoons of ground flaxseeds. 4. Garlic Garlic impedes the liver’s ability to make cholesterol. How to sneak it in: Chop garlic into small pieces to release its flavor. Sauté it with steamed spinach, add it to sauces and soups or purée roasted garlic with cooked potatoes and olive oil for a heart-healthy version of everybody’s favorite: mashed potatoes. Or try this Creamy Cauliflower Puree. Brill’s daily Rx: One clove and one Kyolic One Per Day Cardiovascular aged garlic extract supplement. 5. Phytosterol-Containing Foods Phytosterols are a fat found in plant foods such as fruits, nuts, seeds and vegetable oils. They interfere with cholesterol absorption by blocking it from your intestinal cells. How to sneak it in: Even a vegetarian diet provides no more than 300-400 mg of plant sterols a day, well below Brill’s recommendation. So supplement this with foods containing added phytosterols – chocolate bars, margarine, cheese, granola bars and cookies, to name a few – but keep an eye on saturated fat and trans-fat content. Check out this Cranberry-Almond Granola. Brill’s daily Rx: 2-3 grams of phytosterols a day spread over two meals. 6. Apples Apples, particularly the skin and outer flesh, are rich in polyphenols, powerful antioxidants that help prevent plaque buildup. How to sneak it in: Chop, slice or dice ’em, but leave the peel on for maximum health benefits. Try this Jicama-Apple Slaw recipe. Brill’s daily Rx: One apple – to keep the doctor away, of course. 7. Beans Beans contain a special soluble fiber that’s fermented in the colon. Healthy bacteria eat the fiber and bean sugars to form short-chain fatty acids, which travel to the liver and inhibit LDL cholesterol production. How to sneak it in: Brill loves Adzuki beans, which are used in Japan to make sweet red bean paste. She also recommends cannelloni beans (try them in Tuscan soups, an Italian bean-based soup) and kidney beans, perfect in Southwestern chili. Make this Pasta Bean Soup. Brill’s daily Rx: 1/2 cup of legumes (beans, peas or lentils). 8. Soy Protein Soy protein contains phytoestrogens – compounds that increase the number and effectiveness of LDL cholesterol receptors, improving the liver’s ability to get rid of cholesterol in your bloodstream. How to sneak it in: Order a soy latte at your favorite coffeehouse, throw tofu into a fruit smoothie, use soy flour when baking, or mix a handful of roasted soy nuts with dried fruit for an energy-boosting trail mix. Try this TLT (Tofu, Lettuce & Tomato Sandwich) for lunch. Brill’s daily Rx: 20–25 grams. Two More Tips A healthy diet isn’t your only defense against cholesterol. “Every step works to lower cholesterol in a specific way,” Brill says. “By combining them all, you get an extremely powerful LDL-lowering approach.” Here are two of her favorite non-food-related tips: 9. Work Up a Sweat Brisk exercise speeds blood flow in your arteries, reducing your chances of inflammation and clogging (two precursors to hardening of your arteries). How to sneak it in: You don’t have to hit the gym to get some exercise. Clip on a pedometer while you run errands and aim for 10,000 steps a day. Brill’s daily Rx: 30 minutes of exercise. 10. Take Metamucil (Psyllium Husk) Metamucil contains psyllium husk, a fiber that prevents cholesterol from entering intestinal cells. This fiber soaks up cholesterol so you excrete it rather than absorb it into your body. It’s “the most powerful LDL-lowering viscous soluble fiber in existence,” Brill says. How to sneak it in: Adults should consume 10-25 grams of soluble fiber a day, advises the National Cholesterol Education Program, but most get only 3-4 grams. Brill says you should get half your fiber from a supplement and the rest from food. Take half your daily dose of Metamucil before breakfast and half after dinner to avoid overloading your body on fiber, which can cause gas, constipation or diarrhea. Brill’s daily Rx: Work up to 12 capsules a day, for a total of 6 grams of psyllium husk. Or use the powdered version, which you can mix into water. It varies by product, but most Metamucil powders contain 3.4 grams of psyllium husk per serving. Start incorporating these foods and tips into your lifestyle today. For more on their benefits and for delicious recipes and meal plans (you'll love the walnut-crusted salmon), get a copy of Cholesterol Down and check out CholesterolDownBook.com.

How Hormones Affect Rheumatoid Arthritis Treatments Fluctuating Levels Impact Women with Rheumatoid Arthritis

What do hormones have to do with rheumatoid arthritis, a chronic inflammatory condition that affects 2-3 million Americans? A lot, says a top rheumatologist. And women bear the brunt, going through pregnancies and menopause. Learn more... Women with rheumatoid arthritis often go into remission during pregnancy, and menopause puts them at higher risk of the inflammatory autoimmune disease. The common link? Fluctuating levels of the hormone estrogen, which dramatically increases when a woman is pregnant and decline after her periods cease. Twice as many women than men suffer from rheumatoid arthritis, and one reason may be their hormones, according to a top rheumatologist. "There are about two to three women affected with rheumatoid arthritis for every one man," says Anca Askanase, M.D., assistant professor at the New York University School of Medicine and a clinical researcher at Langone Center for Advanced Therapeutics at the NYU Hospital for Joint Diseases. "That’s the first thing that makes you wonder what the connection is there," she says. In this exclusive Lifescript interview, Askanase discusses the link between rheumatoid arthritis and hormones. How do the hormonal changes in pregnancy affect women with rheumatoid arthritis? Evidence suggests that maybe estrogen is good for arthritis. Rheumatoid arthritis gets better in women during pregnancy. Do women with rheumatoid arthritis go into remission while pregnant? There’s definite improvement – to the point where women who required significant therapy before their pregnancy are OK with limited or no therapy during pregnancy. Is it a long-term improvement? Within the first couple of months after the pregnancy, probably 90% of women have a serious flare and have to go back on their medication. Why does the relapse happen so rapidly? That’s because the amount of estrogen during pregnancy is just enormous compared to what we normally have on daily. Then, during lactation, levels decrease even further because a lot of women stop ovulating for a while after pregnancy. The drop in estrogen is very fast. How does breastfeeding impact rheumatoid arthritis? Breastfeeding is associated with a decrease in rheumatoid arthritis risk. One Swedish study suggested that there’s a protective effect from nursing. However, a [Harvard] study suggests that there’s no clear evidence of [that]. The jury’s still out. Does taking contraceptive pills affect rheumatoid arthritis? As opposed to lupus, where there’s a debate on whether hormone replacement or contraceptives are [beneficial], women with rheumatoid arthritis are never discouraged from taking birth control. There’s no clinical evidence to suggest that there’s either a beneficial or detrimental effect from oral contraceptives. The only catch is to make sure that they do not have antiphospholipid antibodies, which would increase the risk of a blood clot when taking oral contraceptives. Whenever a woman with rheumatoid arthritis asks me about whether she should take birth control, I test her for antiphospholipid antibodies. What are antiphospholipid antibodies? They're antibodies that predict a risk for blood clot. Not everybody who has them develops a clot, but the evidence suggests that if you have them and take [oral] birth control, you're more likely to develop a clot. That’s a factor in general for women with autoimmune diseases who are contemplating birth control. What’s the average age women get rheumatoid arthritis? While rheumatoid arthritis affects women of all ages, it seems to be [more prevalent] in women 40-50 years old. That is yet another piece of evidence that suggests there’s a connection between hormones and rheumatoid arthritis. The hormonal milieu of a woman going through [menopause] is when rheumatoid arthritis happens. Some data suggests that women who go into early menopause have a higher risk of developing rheumatoid arthritis than women with later menopause [onset]. What do you think is the cause? Some evidence suggests that the decrease in estrogen that comes with menopause may have something to do with it. So a lower estrogen level can flip on the rheumatoid arthritis switch? Rheumatoid arthritis is a combination of genetic and environmental factors. A little piece in the genetic factors is [simply being] a woman, and probably a little piece in the environmental factors is related to the decrease in estrogen. But, those factors are definitely not all the answers to the cause of rheumatoid arthritis, because women get this [disease] before their estrogen decreases – and men get it too. What progress have researchers made in finding the cause of rheumatoid arthritis? [Researchers] are still looking at large pools of women to better understand where all these factors play in the relationship between pregnancy, nursing, menopause and development of rheumatoid arthritis. How has rheumatoid arthritis treatments improved over the years? Over the past decade we have understood better how to treat rheumatoid arthritis, so we can prevent the long-term disabilities associated with it. We’ve probably made an impact on the cardiovascular risk too. What current rheumatoid arthritis treatments are available? As of this year, the best rheumatoid arthritis treatment is a combination of methotrexate (MTX), which is the older therapeutic medication, and tumor necrosis factor inhibitors (TNF). TNF promotes the inflammatory response. Over the past 10-15 years – since the medications have been available – it's evident that the combination of methotrexate and TNS inhibitors has the greatest impact on arresting the progression of rheumatoid arthritis. If TNF inhibitors stop the inflammatory response, how does methotrexate work? Methotrexate has been used for chemotherapy [cancer treatment] for about 30 years. In the late ‘80s, it began being used for rheumatoid arthritis. Because it’s a chemotherapy agent, it goes after some inflammatory cells. But in the joint, methotrexate works on adenosine (a naturally occurring substance in the cells),, which is a big player in the inflammatory process. Methotrexate's anti-inflammatory effects may be due in part to the increase in adenosine outside the cells. What are side effects from the treatment? Because methotrexate is a chemotherapy drug, it has some chemo-like side effects. People get nauseous and throw up. They get tired and lose their hair, which for a woman is a big deal. Autoimmune diseases are a hyperactive immune system. We want to take [that] and make it normal. We achieve that most of the time, but occasionally [doctors] overdo it and put some people at risk for infections and malignancies. Do the benefits outweigh the risks? What methotrexate and the TNF inhibitors have done for women with rheumatoid arthritis is amazing. They took people who would be crippled within a couple of years of developing rheumatoid arthritis and helped them maintain their functional abilities for decades. But it comes at a cost. These people are at a slight risk for developing infections and probably at a slight risk for malignancies. How large is the risk? Large cohort studies don’t suggest a huge increase in the risk for malignancies associated with [rheumatoid arthritis] treatments. It also may be inherent in the disease itself. There’s a big [lymphoma] cancer risk in rheumatoid arthritis. How big is the risk of lymphoma? The epidemiology data [shows] the risk of lymphoma is about two times the risk of the normal controlled population. Then the question becomes: How much is due to the disease, meaning the hyperactive immune system, and how much is due to treatment? It’s very hard to tease out. If hormones have an impact, should rheumatoid arthritis treatments be heading in that direction? Estrogen is important. A decrease in estrogen isn’t a great thing. But to say that hormone replacement is protective, nobody has made that jump. Why not try hormonal therapies? We’re not sure that hormone replacement is even good for women. The Women’s Health Initiative [a recent long-term health study] suggested that there are serious health risks related to hormone replacement. So would anyone want that? It’s complex because arthritis is associated with an increased cardiovascular risk and hormone therapies have been linked to that too. Would you want to do anything to further increase that risk?

Best Birth Control Options for Older Women How to Prevent Pregnancy in Your 40s and 50s

If you’re past 40 and think you no longer need to worry about contraception, you’re wrong! Many women in their 40s and 50s still need protection from unwanted pregnancy. Read on for expert advice about your best birth control options… Many women slack off on contraception when they reach midlife because they think it’s impossible for them to get pregnant anymore. “After 40, women may not have sex as often as they used to, plus they perceive themselves to be less fertile” – but that’s not always the case, says Victoria Jennings, Ph.D., director of Georgetown University’s Institute for Reproductive Health in Washington, D.C. Menstrual irregularities, including skipped periods, are also more common for women in their 40s and 50s, contributing to their false belief that they no longer need to take precautions, adds Andrew M. Kaunitz, M.D., professor and associate chairman of the department of obstetrics and gynecology at the University of Florida College of Medicine-Jacksonville. Fertility does decline with age, but if you don’t want to get pregnant – and choose not to undergo sterilization – you should use contraception until a full year has passed since your last spontaneous menstrual cycle, Kaunitz says. As you get older, however, the best birth control method for you may change. So if you’re heading past your 40th birthday, here’s a rundown of the top contraceptive options for older women, along with their pros and cons. Birth control options in your 40s and 50s: Combined oral contraceptive pills (the pill) How they work: The pill contains specific amounts of the hormones estrogen and progestin, which block ovulation and prevent fertilization. Pros and cons: The pill comes in various formulations, some of which can regulate your menstrual cycle, reduce its intensity and duration of flow, lessen cramps and decrease premenstrual syndrome symptoms, such as swollen or tender breasts, fatigue, headache or backache, joint or muscle pain, anxiety or depression. For maximum effectiveness, take your pill at roughly the same time every day. Common reported side effects include nausea, weight gain, decreased libido and headaches, but it isn’t clear to what extent (if any) the pill contributes to these. Who it’s for: The pill often is a good choice for women who are lean, healthy and don’t smoke. Women smokers on estrogen pills face a higher risk of blood clots, stroke, or heart attacks. The pill isn't for you if you have an underlying health condition that could be affected by estrogen, including obesity, high blood pressure, or a history of blood clots, migraine headaches or breast cancer. Reliability: 91%-97% Expert advice: “For lean, nonsmoking older women, the pill has [both] contraceptive and non-contraceptive benefits,” Kaunitz says. “It can reduce irregular perimenopausal bleeding and hot flashes and help prevent ovarian cancer. [It] may also decrease the risk of postmenopausal fractures [due to osteoporosis].” Birth control options in your 40s and 50s: Progestin-only oral contraceptives (the mini-pill) How they work: Mini-pills, which contain the hormone progestin but not estrogen, thicken cervical mucus and thin the uterine lining, preventing sperm from reaching and fertilizing an egg. Pros and cons: Mini-pills can make your periods shorter and lighter. However, they must be taken at the same time each day to be effective; you need to use a backup birth control method if you take mini-pills more than three hours late. Common side effects include unpredictable bleeding, weight gain or frequent yeast infections. The mini-pill also may increase the risk of ovarian cysts. Who they’re for: These can be a good choice for older women who can’t use estrogen-based contraception. Still, your doctor may caution against them if you have certain medical conditions. Reliability: 91%-97% Expert advice: “The mini-pill [is useful] for some older women, such as those who are overweight or continue to smoke,” Kaunitz says. Birth control options in your 40s and 50s: Vaginal ring How it works: A thin, transparent, flexible ring that you insert into the vagina yourself, the vaginal ring releases the same hormones as those in combination oral contraceptives, blocking ovulation and altering the uterine lining to prevent fertilization and implantation. You leave the ring in for three weeks, followed by a week off. Each vaginal ring is effective for one month. Pros and cons: Like the pill, the vaginal ring often makes periods more regular and may lessen cramps – both of which can be important for women approaching menopause. On the downside, it can increase vaginal discharge. Side effects are similar to those of combination oral contraceptives. Who it’s for: The vaginal ring is often a good choice for older nonsmoking women who have no underlying health problems. However, if you smoke or have a health condition that could be affected by estrogen – such as a history of breast cancer, migraine headaches or blood clots – the vaginal ring isn’t for you. Women who are obese or have high blood pressure should also avoid the ring. Reliability: 91%-97% Expert advice: “The vaginal ring is a fine birth control method for many older women,” Jennings says. “As with all estrogen-containing methods, though, there can be side effects, such as breakthrough bleeding, bloating and headaches. But side effects are just as likely in older women as in younger ones.” Birth control options in your 40s and 50s: Intrauterine device (IUD) How it works: When this small, T-shaped device is placed inside a woman’s uterus, it changes the uterine environment in ways that prevent sperm from reaching an egg or stop a fertilized egg from implanting. Two types of IUDs are available in the U.S.: ParaGard, which is hormone-free, and Mirena, which contains progestin. Both must be inserted and removed by a doctor. Pros and cons: IUDs can often stay in place for years at a time. ParaGard, which contains copper, may increase menstrual bleeding and cramping. Mirena can lighten or eliminate monthly periods, and it may be especially appealing to women with heavy bleeding problems. However, Mirena may cause acne or ovarian cysts in some women. Who it’s for: The IUD is an effective birth control method for most women, especially if they don’t want to take medication daily. It can be good for many women in their 40s and 50s, including those who are obese. Reliability: Better than 99% Expert advice: “The IUD is the best birth control method for women in their 40s and 50s, because if it’s placed at an appropriate age, they’ll be able to use it until they enter menopause,” says Natasha Withers, D.O., a family medical doctor at One Medical Group in New York City. “There are very few contraindications [or] side effects.” Birth control options in your 40s and 50s: Hormonal implant (Implanon) How it works: Implanon is a flexible, matchstick-sized rod that’s inserted under the skin of your upper arm. It releases a steady dose of progestin, which prevents fertilization. Pros and cons: Hormonal implants, which must be inserted and removed by a physician, can remain in place for as long as three years, so you don’t have to remember to take medication every day. Common side effects include irregular and unpredictable bleeding or spotting. Some women stop having periods while on Implanon. Who it’s for: Implanon is a good birth control method for most healthy women in their 40s and 50s. However, it can interact with some medications, including antibiotics. So tell your doctor about all prescription and over-the-counter drugs and supplements you’re taking. Reliability: 99% or better Expert advice: “Women with hormonal implants can achieve contraception as effective as sterilization without surgery, or the need to make irrevocable decisions,” Kaunitz says. Birth control options in your 40s and 50s: Condoms – male and female How they work: Condoms prevent pregnancy by creating a physical barrier to keep sperm from reaching an egg. Female condoms are inserted into the woman’s vagina. Both are available in different sizes. Pros and cons: Condoms don’t require a prescription and are widely available. Plus, they help protect against STDs. However, some older women may experience vaginal dryness during intercourse, so condoms may be uncomfortable unless accompanied by lubricant. (Avoid oil- or petroleum-based lubricants, because they can degrade the condom.) Condoms also can decrease sensation, and female condoms may be noisy. Some couples find them difficult to use correctly, which decreases their effectiveness. Female condoms may be difficult to find in stores but can be purchased online. Who they’re for: A lack of side effects makes condoms a good choice for many older women. Unless you’re in a committed relationship and are sure that neither partner has an STD, you should use condoms to protect against STDs – even if you’re past menopause or are also using another method of birth control, according to the National Institute on Aging in Bethesda, Md. Reliability: Male condom: 85%-95%; female condom: 79%-95% Expert advice: “Condoms aren’t just for teenagers,” Kaunitz says. “Mature women [are likely to] use condoms more consistently, and therefore more effectively, than younger women." Other birth control options The following are less frequently recommended for older women: Diaphragms and over-the-counter spermicides have a relatively high failure rate and generally aren't considered as effective as the top choices. Progesterone injections (Depo-Provera) may increase the risk of osteoporosis and weight gain, says Philip Baird, M.D., a family medicine doctor and birth control counselor at One Medical Group in New York City. The hormonal patch (Ortho Evra) causes higher levels of estrogen to circulate in the body compared with combination birth control pills. That may lead to a slightly higher risk of side effects. Be sure to discuss all your health conditions with your doctor when making decisions about birth control. To learn more about your contraceptive options, visit our Birth Control Health Center. Women's Health: How Much Do You Know? How you take care of yourself has a huge impact on your future, affecting everything from your ability to have children to your risk of heart disease. There's no substitute for good health, and when it's gone, it's often gone for good.

Expert Advice for Restless Legs Syndrome A Holistic Approach to RLS Treatment

Sure, medications can treat restless legs syndrome, a neurological disorder that causes a person to constantly move around. But what about alternative treatments? Find out one doctor’s natural remedies – how they work, the benefits and possible side effects… For those who prefer a holistic approach to treating restless legs syndrome, Jacob Teitelbaum, M.D., medical director of the Fibromyalgia and Fatigue Centers of America and author of From Fatigued to Fantastic (Avery Trade), answers questions about how best to calm those jumpy limbs. What causes restless legs syndrome? We don’t know why people get restless legs syndrome. But there is an area of the brain that is the neurotransmitter of dopamines, which is very important. Dopamines are brain-signaling chemicals – the movement center of the brain. A dopamine deficiency is an iron deficiency. You need iron to make dopamine. How is RLS diagnosed? Usually with a sleep study, where people spend the night in a sleep lab to check if their legs are jumpy and interfere with sleep. I recommend that, instead of paying for a sleep study right away, people should just videotape themselves sleeping at night. Set up a video camera pointing at your feet with your head in the background. Sleep under a sheet instead of a blanket and you’ll see whether you have jumpy legs. Does physical activity help? Not really. When you walk around and you’re active, you have so many nerve signals going to your feet telling them what to do, where you are and so on that it overrides the signal to move your legs. That won’t affect what happens later in the day when you want to fall asleep or rest. Is RLS more prevalent in women than men? It’s very common to see restless legs syndrome in fibromyalgia patients. About a third of the people who have fibromyalgia have restless legs syndrome. These autoimmune diseases seem to predominantly [affect] women. It’s quite possible that restless legs syndrome has an autoimmune component. Why does it seem to affect women more? Think about it: If a woman carries a baby, she needs to be able to carry a baby without rejecting the little bugger. If you put a baby into a man, that immune system is going to say, “That’s not me!” and kick it right out. A woman is built differently to be able to carry babies throughout pregnancy. Because of that, some diseases are more common in men, but most autoimmune diseases are more common in women. Iron deficiency is much more common in women because until they go through menopause, there is a monthly iron loss with their periods. What can help? Treating an iron deficiency is effective. Iron is dirt-cheap and cures the problem. It costs five cents a day, and after six months, if you get the iron levels high enough, the restless leg syndrome goes away and you’re done. How can you check your iron levels? You should have a simple blood test called a ferritin test, and any doctor’s office can get it for you. If your ferritin level is over 60, you don’t need iron, but if it’s less than 60, studies show iron treatments will help your restless legs syndrome. Take vitamin C with the iron to absorb it, and do so on an empty stomach. Take it at bedtime until your ferritin level is at least 60. Is taking iron safe? Get the ferritin test, but again, you have to get the results from the doctor. If your ferritin level is under 60, it’s quite safe to take the iron. What side effects can be expected? A. Iron will cause a black stool, which it’s normal for iron to do. B. If you’re taking thyroid medication, iron can interfere with the absorption of that. Thyroid and iron should not be taken within six hours of each other. Also iron is better absorbed with vitamin C. C. If you get iron from liver and foods like spinach and vegetables, you need to add at least 100 milligrams (mg) of vitamin C with the dose. See if that works. D. Some people will get constipation, which leads me to the next one for treatment of restless legs syndrome, which is magnesium. Magnesium is kind of like your body’s natural Valium, but it gives you energy and calms down the nervous system. So, it’ll tend to decrease seizures and reduce tremors. It decreases restless legs syndrome – and it’s healthy for you. The magnesium has a mild laxative action, whereas iron is mildly constipating. So, that makes a great team. What are the therapeutic doses for the magnesium and iron? You can take 500 mg of magnesium a day. You can take it at bedtime so that it helps you sleep, or you can divide it up through the day. That is 200 mg per dose, but you can go as high as 500 if it’s not causing you uncomfortable diarrhea. I recommend the iron dose be 25-30 mg a day followed by 100 mg of vitamin C. The problem with iron is that taking more won’t really get your blood levels up much more quickly. It’ll just cause you to be constipated and nauseated. In fact, if you take it every other day, or three weeks on and one week off, you get almost as much absorption with less stomach upset. If you get a bit of gastritis, gastritis decreases the absorption. The bottom line is it’s OK to take iron at a level that’s comfortable because if you’re getting an upset stomach, you’re not getting the absorption anyway. What if you do get sick from taking iron on an empty stomach? If that happens, take it with food or lower the dose. There is an iron supplement out there called Floradix, which is an herbal mix. It doesn’t have much iron in it, but it’s easy on the stomach. And if you need to, can you still use medication? Yes and I’m going to recommend Gabapentin or Zolpidem. Those are both generic, and they’re both cheap. I would start with Gabapentin – 100-600 mg a day at bedtime [is] shown to help restless legs syndrome. For more information, visit our Restless Legs Syndrome Health Center. These following resources may also provide valuable information and support to help you manage your condition: Foundations and Associations RLS Foundation This nonprofit provides current research, articles and support groups to people with restless legs syndrome. We Move This nonprofit organization has up-to-date medical research about restless legs syndrome. National Sleep Foundation RLS is among the variety of sleep disorders that the foundation offers facts and information about. Books Restless Legs Syndrome: Coping with Your Sleepless Nights by Mark J. Buchfuhrer, M.D., Wayne A. Hening, M.D., and. Clete A. Kushida, M.D. (Demos Health) Written by restless legs syndrome experts and sponsored by the American Academy of Neurology, this book explains the facts behind RLS, its causes and how to manage it. Restless Legs Syndrome: Relief and Hope for Sleepless Victims of a Hidden Epidemic by Robert H. Yoakum (Fireside) An RLS sufferer provides information on the causes and coping mechanisms for this disorder. 100 Questions & Answers About Restless Legs Syndrome by Sudhansu Chokroverty, M.D. (Jones & Bartlett Learning) The 100 most-asked questions about restless legs syndrome answered. Restless Legs Syndrome: The RLS Rebel's Survival Guide by Jill Gunzel (Wheatmark) An RLS victim and ovarian cancer survivor writes about fighting back when faced with debilitating challenges. Clinical Management of Restless Legs Syndrome by Wayne A. Hening, M.D., Mark J. Buchfuhrer, M.D., and Hochang B. Lee, M.D. (Professional Communications) This books explains how to accurately diagnose and treat RLS. Contemporary Diagnosis and Management of Restless Legs Syndrome by David Bruce Rye, M.D., Ph.D. (Handbooks in Health Care) A neurology professor and sleep disorders specialist discusses the causes, and diagnostic and treatment methods for restless legs syndrome. Blogs Restless Leg Syndrome Foundation Blog This blog gives readers information about restless legs syndrome and the RLS Foundation. Restless Leg Tips This blog provides tips and suggestions for people suffering from restless legs syndrome. Support Groups RLS Foundation Online Community Members can create profiles and connect with others. The Restless Legs Syndrome Foundation has a link that helps readers find support groups in their area. Southern California RLS Support Group This group provides information on meetings, expert medical consultations and patient letters for restless legs syndrome. What’s Your Restless Legs Syndrome IQ? Restless legs syndrome (RLS) might sound like a simple case of someone feeling on edge. After all, many people shake their legs when they’re antsy, bored or nervous.

Why Diabetes Is Riskier for Women

One out of every 10 American women is living with diabetes, which causes more deaths each year than breast cancer and AIDS combined. Still, most Americans don’t see it as a serious disease. Here’s why women should worry... Are you overweight and hate working out? Were you diagnosed with gestational diabetes during a past pregnancy? If you answered yes to either of these questions, you’re at risk for developing diabetes, a chronic, incurable disease that raises the risk of heart disease, kidney failure and more. Diabetes poses special problems for women. It increases your chances of having complications during pregnancy, such as birth defects, miscarriage and large babies. And women with the disease are also more likely to die younger. “If you see a 40-year-old woman with chest pain, she’s [not] likely to have a heart attack,” says Andrew Drexler, M.D., an endocrinologist and director of UCLA’s Gonda Diabetes Center. “But if she’s diabetic, that’s not true.” The federal government spends billions each year conducting diabetes research, with scientists searching for more efficient ways to manage the disease. What are the latest advances and how are women affected by the disease? For answers, we sat down with Drexler, who heads one of the nation’s leading diabetes treatment centers. Read on for his recommendations. What’s the difference between type 1 and type 2 diabetes? Type 1 is an autoimmune disease that destroys islet cells [which produce insulin] in the pancreas. Insulin controls [blood sugar levels] in the body. [With] type 2 diabetes, the insulin is there, but it doesn’t work – not because the insulin isn’t normal but because the body doesn’t respond to it well. The body compensates by producing more insulin. Type 1 used to be called "juvenile onset diabetes" and type 2 "adult onset." We’ve eliminated those terms because many people didn’t fit [into those categories]. Now more kids have the adult form and vice versa. What causes diabetes? We really don’t know what causes type 1. There’s no way of avoiding it. There is a genetic component to it, but we don’t fully understand the trigger. That’s why even if we were to catch it early, we couldn’t prevent it. Type 2 is [largely caused] by eating too much and not being active enough. The data are pretty strong that the problem is the calories – not the type of food. Read 13 Ways to Prevent Diabetes. Which type is more common? Between 90%-95% of diabetics have type 2. We’re seeing an increase in both types, but type 2 is being called an epidemic. That appears to be true worldwide. As obesity becomes an epidemic, so does type 2 diabetes. It's that simple. Are the symptoms the same for type 1 and 2? Type 1 develops rather quickly, with dramatic symptoms occurring within a week to a month. Symptoms include frequent urination, weight loss, blurry vision and thirst. [Symptoms are] the same with type 2, but it develops more slowly. Can someone be diabetic and not know it? The feeling used to be that 50% of type 2 cases were undiagnosed. It’s better now, but still grossly undiagnosed. [Being diagnosed with type 2 diabetes] is more likely to happen as you get older. Actually, something like 25% of people in their 80s have diabetes. What problems do women have in managing diabetes? Women are thought to have a harder time with weight than men. Excess weight makes everything worse: It makes it harder for insulin to work. You can’t produce enough insulin for your body’s needs. The more overweight you are, the more you have to produce. How does pregnancy affect a woman with diabetes? When a woman’s pregnant, the placenta produces hormones that make women more insulin-resistant. That’s why they develop gestational diabetes and often end up on insulin when pregnant. Nature doesn’t care a lot about you: It cares about you having children. There are a number of hormones made by the placenta – most are designed to be good for the baby and the hell with you. What role does diet play in preventing or managing diabetes in women? A restricted diet isn’t the most important part of preventing diabetes; women have to eat the right things. [The best diet for diabetics includes whole grains, fresh fruits and vegetables, low-fat cheeses and yogurt, and baked or broiled fish and meats.] How does menopause affect diabetes? Menopause doesn’t have any direct impact on it. But women often find it hard to control their diabetes because menopause is stressful, and with any stress, diabetes is going to get worse. Stress hormones cause a number of actions that can counteract insulin’s effect. For example, stress causes the release of glucose by the liver, which raises blood sugar. Can you manage diabetes without medication? Most type 2 patients end up on medication. (The starting medication is metformin.) Exercise is critical. Most doctors would say that cardiovascular exercise [is important], but there’s some evidence that increasing muscle [through resistance training] may help as well by increasing the use of glucose. What about insulin? Patients may want to stay off insulin, but most physicians feel we don’t start insulin soon enough. At some point, in almost all cases, medications fail, and when they do, the only alternative is insulin. The goal isn’t staying off insulin; the goal is keeping blood sugars under control. Gastric bypass surgery is sometimes touted as a type 2 remedy. Is this true? It seems effective. Often diabetes gets better as the weight comes off. But gastric bypass surgery also has complications. Doctors have to determine how obese an individual needs to be before you expose them to surgery. At this point, most [doctors] would consider the procedure for only really obese people – those with a body mass index (BMI) of 30 to 35, which is a measure of body fat based on height and weight. [To calculate your BMI, click here.] For example, a woman who’s 5’4” and weighs 175 pounds would have a BMI of 30. Once you get above a BMI of 35, benefits outweigh risks. One type of gastric bypass surgery, the duodenal switch, is getting a lot of attention for supposedly curing diabetes. What should people watch for with this procedure? [The surgery] bypasses absorption. [It limits the amount of calories and fat absorbed from food.] But there’s some concern that you’re not absorbing enough vitamins. Most [doctors don’t] see this as a cure for diabetes. It’s a cure for morbid obesity and diabetes. What about 7-day wireless blood sugar monitors, which chart trends in blood glucose levels after a diabetic punches in daily information from finger stick tests? Do they work? They can be very helpful, and we’re recommending them. But the Food and Drug Administration (FDA) says they shouldn’t [replace] finger sticks [in which a needle pricks a finger to test blood sugar level] because the monitors aren’t accurate enough yet. For example, if someone goes to bed with 120 blood sugar, according to a monitor, and wakes up with 250, does that mean they need more insulin overnight – or do they have too much and are rebounding? We need better products [to monitor blood sugar levels]. What’s your best advice for women with diabetes? Don’t try to pretend it doesn’t exist. Learn how to control it, rather than letting it control you. As a society, we’re not good at exercising and following a diet. There are clearly genetic factors that make it harder for us to lose weight as we get older. We don’t know why, and this will be a major area of research over the next 20 years. But it’s good to work with a diabetes counselor [who can create healthy diet and exercise plans]. The key point is to eat a healthy, balanced diet. There is no gimmick diet. It’s a marathon, rather than a sprint. It’s all about behavior modification. Want to learn more? Check these websites for information: Lifescript's Diabetes Type 2 Health Center Centers for Disease Control and Prevention Diabetes Fact Sheet National Diabetes Information Clearinghouse (NDIC) National Institute of Diabetes and Digestive and Kidney Diseases American Diabetes Association CDC-Take Charge of Your Diabetes: Pregnancy and Women’s Health How Much Do You Know About Diabetes? In the United States alone, 23.6 million people have diabetes. And 5.6 million of them don’t even know it. Unfortunately, misinformation about diabetes is rampant – and mixing up the facts about this disease can have dire consequences.

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Constant Urge to Urinate? 12 Tips to Manage OAB Naturally Learn the First Steps to Help an Overactive Bladder

Are you skipping excursions with friends because you’re worried a bathroom won’t be in arm’s length? You’re not alone. Overactive bladder (OAB) doesn’t have to cramp your style or your social life. Find out 12 natural ways to manage that frequent urge to urinate... Do you have the path to the mall restroom mapped? Are you afraid to leave home because there won’t be a bathroom nearby when you need one? That’s the reality for the millions of women who suffer from overactive bladder (OAB). In fact, 17% of all women over age 18 have OAB, according to the National Association for Incontinence (NAFI), an education and advocacy association. So why does OAB have you living in the ladies’ room? And what exactly are the underlying causes of the urge to urinate? The condition occurs when your brain sends signals to the bladder at the wrong time, telling the organ that you need to urinate. Your bladder responds by contracting and you feel the urge to go – frequently, sometimes urgently and certainly more than “normal.” While its causes are unknown and the condition isn’t dangerous, OAB’s symptoms are annoying and embarrassing, forcing women to plan their lives around it. But here’s good news: OAB is very treatable and a range of medical and surgical options are available. However, changing daily habits is the first course of treatment – simple steps, such as watching fluid intake and doing Kegel exercises. Here are 6 do’s and 6 don’ts to get you started: The Don’ts 1. Don’t squat when you pee. It’s important to really empty your bladder every time you go, says Elizabeth Kavaler, a New York urologist and author of A Seat on the Aisle, Please! (Springer). When you hover over the toilet, you can’t empty your bladder well. “[Women] squat and don’t take the time they need,” Kavaler says. Her tips? Don’t squeeze your legs and don’t restrain and hurry. “You need to take the extra 30 seconds,” she says. What if you’re using a public restroom? “Put paper on the toilet seat and sit.” 2. Don’t drink 8 glasses of water a day. The adage that 8 glasses of water is good for your health doesn’t apply if you have OAB. In fact, it may be the cause of it, says Sandra Valaitis, M.D., chief of Gynecology/Reconstructive Surgery at University of Chicago Medical Center. As part of OAB treatment, Valaitis asks her patients to keep a diary of everything they drink and when they urinate. “I’m amazed so many times what patients are drinking without even realizing it,” she says. “I had one 25-year-old woman [who] was drinking 120 ounces of Pepsi a day and hadn’t even thought about how that would impact her bladder control.” What’s the right amount? Four to six glasses of water a day is enough for most people – a little more if you exercise vigorously and sweat, says Ariana Smith, urologist and assistant professor at the University of Pennsylvania in Philadelphia. 3. Don’t drink too little. You want to decrease your fluid intake but not too much: Too little can irritate the bladder, so you still may feel that constant urge to urinate.It can also lead to urinary tract infections (UTIs), because the urine becomes concentrated (and turns dark yellow and smells) due to dehydration. That leaves bacteria behind. How do you know if you’re drinking the right amount? Your urine should be clear and odor-free. 4. Don’t go for the cranberry cure. Even though cranberry juice is a UTI folk remedy, it’s not good for your bladder, says Kavaler. It doesn't hydrate well or flush out toxins. In fact, it’s a sugary diuretic and OAB sufferers should steer clear. “Drink water when you’re thirsty and eat a well-balanced diet as part of a healthy lifestyle,” she says. 5. Don’t give up sex. Sex doesn’t cause OAB or make it worse, so there’s no reason to give it up, says Smith. Sure, the condition can make women uncomfortable during sex because they feel the urge to urinate and worry they might have an accident. But these conditions go away when OAB is treated, she says. Limiting fluid intake before having sex also may relieve discomfort, suggests Kavaler. 6. Don’t obsess about peeing. “There's no such thing as ‘normal’ urination,” Kavaler says. “Whatever makes you functional is normal.” Obsessing when, where and how you go, she says, only leads to stress. And that can make many women experience even more frequent urination because when they're stressed, they tend to drink more liquid – creating an endless cycle. If you’re urinating more than is practical and it’s bothersome, see your doctor, Kavaler says. The Do’s 1. Do Kegel exercises. Kegel exercises strengthen pelvic-floor muscles and short-circuit the urge to urinate, Smith says. “If you have good pelvic floor muscles, you can suppress your urge to go,” she says. Kegel exercises are simple squeezes you can do at home, contracting your pelvic-floor muscles as if you’re trying not to pee. (Don't do these if you have a full or partially empty bladder, says Edward Geehr, M.D., Lifescript Chief Medical Officer. It can lead to UTIs.) Even better: You can do them anywhere without anyone noticing – at your desk at work or while watching TV. 2. Do cut back on the mocha lattes. Caffeine in coffee, tea, soda – even chocolate – has a diuretic effect: It makes your bladder fill quicker so you have to urinate. It may also irritate it. “Eight ounces of coffee seems to be harder on the bladder than 8 ounces of water,” Smith says. “So go with water.” The good news: “A lot of women come back after they’ve eliminated caffeine and their OAB symptoms are significantly better,” she adds. 3. Do set a pee schedule. The brain can tell your body that you have to go, even if you don’t. “Your bladder might get used to holding a smaller amount and it doesn’t want to stretch [to hold more urine],” Valaitis says. So you need to "train" it to go when you want to go, she says. “One treatment is to teach patients how to gradually increase intervals between voidings,” she says. To do this, you have to keep a diary of when you urinate to find a pattern. You may also be asked to measure your output in provided containers to determine when you really need to go and when you don’t. A recommended interval between bathroom breaks is 2-1/2 hours, Valaitis says. If you’re going more often, longer intervals between bathroom breaks will gradually be introduced, Kavaler says. But finding your own rhythm is what’s most important for overactive bladders, she says. “Everyone has their issues and you have to know your body and its requirements.” 4. Do manage your medications. Drugs you take for other conditions may trigger OAB, including blood-pressure drugs, diuretics, muscle relaxants, sedatives and antidepressants, Valaitis says. Others cause dry mouth, which may make you drink more water, causing OAB symptoms. “It’s good to take a look and maybe change the time of day when you take your medication.” You may be able to make simple adjustments, such as not taking the medication at night or when you’re going out. 5. Do maintain a healthy weight. Being overweight puts extra pressure on the bladder and increases the risk of developing bladder problems. Even if you lose a little weight – as little as 5% in overweight or obese women – you can regain bladder control, according to a study of 338 heavy-set women conducted by a University of California, San Francisco researcher, which was published in 2009 in the New England Journal of Medicine. 6. Do seek further treatment. If a change in habits doesn’t work, anticholinergic medications, such as Detrol and Ditropan, may alleviate the urge to urinate by blocking the nerve signals to the bladder. Minimally evasive surgery is also an option – either the insertion of a bladder pacemaker or Botox injected into the organ to relax the muscle and minimize the sensation that you need to urinate all the time. Are You Having Bladder Problems? Leak when you laugh? Have a constant urge to pee? Incontinence is a problem that can be managed. Knowing the causes and common triggers can help you stay dry and out of the bathroom.

Dara Torres: Not Slowing Down for Age or Arthritis

Watching her zip across a pool, you’d never know Dara Torres has arthritis. In this Lifescript exclusive, the 45-year-old swimming champion opens up about surgeries, her secrets to staying in shape and the possibility of an unprecedented sixth attempt at Olympic glory... At the 2008 Beijing Olympics, Dara Torres captured three silver medals and proved that age is no obstacle to athleticism. Nor was osteoarthritis, a degenerative joint disease that affects nearly 27 million people in the U.S. She swam through the pain in her right shoulder, her first sign of the disease. After returning to the U.S., she underwent arthroscopic surgery, a minimally invasive procedure to repair joint damage in that area. But her shoulder was just the start. Next, she faced potentially career-ending deterioration in her left knee. To repair that, Torres underwent a more radical procedure to reconstruct the joint, using biotechnological advances to grow new cartilage. The toughest part for this hard-driving five-time Olympic swimmer? Taking things slow during a year-long recovery. She used the time to write her second book, Gold Medal Fitness: A Revolutionary Five-Week Program (Crown Archetype). Lifescript caught up with Torres, mom to a 6-year-old daughter, Tessa. Read on for her tips on staying fit as you age, coping with arthritis and maintaining a winning attitude. How did the surgery help your shoulder? The arthroscopic surgical procedure shaved down the ends of the bone and removed calcification caused by arthritis. How about your knee? The arthritis in my knee was from overuse. In addition to swimming, I’m a runner, and over the years the combination of exercise and age led to cartilage degeneration. How was that treated? I had reconstructive surgery in 2009 because I was having a lot of pain – it was hard just to walk around the house or play with my daughter. The procedure I had, autologous chondrocyte implantation, replaced cartilage in my knee, since I had little left. How are you doing now? I’m not limping anymore! I feel good. I’m still in physical rehab, but my knee feels better every day. Does your age make it harder to stay in shape? I just turned 45, and I’m in the best shape of my life – fitter than I was in my 20s and definitely more flexible. On the other hand, I need to listen to my body as I get older. It takes me longer to recover between workouts. What should women know about growing older? Age shouldn’t be the defining factor in your life. But with it comes wisdom and experience. I’m a much better person, athlete and mother today than I would have been at 30. It’s possible to achieve your dreams at any age if you really believe in yourself and have perseverance. Is that what motivated you to write your first book? I wrote Age Is Just a Number [Broadway Books] about my decision to compete in the 2008 Olympics after retiring from swimming. It had been eight years since my last Olympics and I was returning at age 41, 15 months after giving birth to my daughter, and I was competing against athletes half my age. What inspired you to write your book, Gold Medal Fitness? It was in response to all the questions I received after the Olympics. People wanted to know how I got back in shape at my age, what my diet was like and the exercises I did. Gold Medal Fitness combines a nutrition plan with Ki-Hara resistance stretching and strengthening exercises. What’s Ki-Hara? It’s a resistance stretching method designed to make you feel balanced, targeting areas of the body that you’re aware need stretching as well as those that you may not notice. The result is a feeling of being fully stretched and loose. I discovered Ki-Hara about 10 years ago when I realized I needed more flexibility. It changed the way I move – in and out of the water. It’s also helped combat some of my knee pain. Do you follow a special diet? Rather than eat three square meals, I have several small meals throughout the day with a balance of protein, fat and high-fiber carbohydrates. Do you have any food vices? I battled bulimia years ago and never want to go back to that dark place. If I crave something, I allow myself to enjoy it in moderation. I try to eat healthy and find a balance, rather than depriving myself of foods I love. I have a sweet tooth and like to have a small dessert after dinner, like a Fudgsicle or a Skinny Cow ice cream bar My weakness right now is homemade Rice Krispies Treats made without butter. I take a pan and spray it with Pam cooking spray, throw in marshmallows and microwave until melted. Then I add Rice Krispies cereal. They taste just like the ones you buy. Do you ever have trouble getting motivated to work out? Sure, I’m like everyone else. So I try to set short-term goals to help me stay motivated. I also really like the way I feel after a workout. What’s a typical training day like for you? I have breakfast with my daughter, take her to school, then spend two hours in the pool. I also do about 1 to 1-1/2 hours of strength and resistance-training exercises. Then I have lunch, do some stretching and pick up Tessa from school. I’m like any other working parent who tries to find a good balance between work and family time. Do you see swimming as a job? I still love to swim. I also loved running, but haven’t done much of it since I started having knee problems. Do you have any down time? Not really. I’m always on the go, either training or spending time with my daughter. My only down time is when I’m sleeping. My “me time” is spent in the water – I feel a real connection with it. When did you first start swimming? I grew up in Los Angeles and had four older brothers who loved to swim. I always wanted to do everything they did, so I started swimming at an early age and swimming competitively at age 8. Will you be competing at the 2012 London games? If it's not too tough on my body and I do well, I [will] compete there. [I’m going] for it one more time. Do you see Tessa following in your footsteps? She likes swimming, but she’s also very active in soccer, tennis and gymnastics. I try to keep her busy, because I don’t want her to spend a lot of time just sitting at home and watching TV. She can choose whatever she wants to do when she gets older, and I’ll support her decision. Symptoms of Arthritis If you suspect you have osteoarthritis, consult your doctor. Common symptoms include: Pain in the joint Most commonly affected joints are those of the knee, hip, hand or spine Pain usually increased when the joint is used or stressed Pain is usually decreased by resting the joint May be described as a dull, achy pain or a sharper, stabbing sensation Stiffness Stiffness can make everyday activities difficult, such as leaning down to pick something up, putting on shoes, opening a jar, walking or climbing stairs Stiffness occuring first thing in the morning is common, usually lasting under 30 minutes after you resume activity Stiffness after any period of inactivity is common (such as after sitting still for a couple of hours in a movie theater or on an airplane) Stiffness decreases your range of motion, so that you can't bend or unbend a joint as far as you normally could.

How to Heal Your Back Problem Top Specialist on How to Fix and Protect a Painful Back

We shell out billions of dollars a year in search of back pain relief. But which treatments are worth the money? In this exclusive Lifescript interview, a top orthopedic surgeon and sports medicine specialist explains what to do when you’re laid low by a painful back, and how to keep your spine healthy the rest of the time... Muscle and joint complaints have surpassed the common cold as the leading reason for doctor visits, and lower back problems lead the charge. An astonishing 80% of Americans are walloped off their feet with back trouble at some point in their lives, says Nicholas DiNubile, M.D., an orthopedic surgeon in Havertown, Penn., who specializes in sports medicine. In his best-selling book FrameWork (Rodale Books), DiNubile explains how to safely start, maintain and build a lifestyle and exercise program to boost muscle, bone and joint health. A follow-up book, FrameWork for the Lower Back (Rodale Books), provides common-sense advice for preventing and treating disk problems, sciatica, and other conditions that leave us with stiff, achy backs. If you’ve ever had back pain, it’s especially important to practice healthful habits, he says. Even a brief back episode can put you at risk for trouble later. “The No. 1 predictor of a [future] back problem is a previous back problem,” he says. “It’s like a warning shot.” DiNubile should know. Not only has he worked as an orthopedic consultant to the Philadelphia 76ers pro basketball team and Pennsylvania Ballet, but he’s also had his own longstanding back issues. In this edited Lifescript interview, he shatters myths about bed rest, back surgery and medical imaging techniques, and explains safe ways to stay active when you’ve literally been knocked flat on your back. How did your back problem start? I had a friend, [and] we used to clown around every year on the beach. He’d come find me, and tackle me just to say hi, and we’d laugh it off. But one year, he came from behind and just hyper-extended my back in a way it was never meant to move. I wound up on all fours and had a hard time standing up. That was the beginning of some big struggles. How did you deal with your back problem? For a while, I put up and just tried to work around it. And there are plenty of days now when I have tightness and aches, and I suck it up and carry on. You’re a surgeon – did you consider surgery for your back problem? No. I knew there wasn’t a surgical option that would apply. The majority of back problems don’t require surgery. There’s probably way too much back surgery in this country. What finally helped you? A combination of things. I changed my mattress to one that was more accommodating, with a layer of memory foam on top. And I modified my exercise routine to put the focus on core workouts. But what really helped me was a chiropractor. How did that help? For 12 years, I was the doctor for the 76ers, and we had an excellent chiropractor. At games, when the players were on the court, I would have him work on me. Because of the injury, my back is vulnerable and tightens up. He’d mobilize the affected [muscles] and get them functioning. I’d use the opportunity to do my own work on my back problems, especially core strengthening and stretching. Many people who never suffered a traumatic injury wind up with a chronic back problem and pain. Why? You don’t have to get tackled by a maniac. The spine is pretty vulnerable, and little things can get to you. People hurt themselves bending over to tie a shoe. I tell people to watch their BLT’s – bending, lifting and twisting. What are other common triggers of back problems? Sitting too much. People think it relieves stress, but it puts heavy force on the spine. Poor aerobic condition also makes you more vulnerable. Muscles need oxygen, and disks and ligaments need a good blood supply to stay healthy. That’s one reason smoking is damaging to your entire frame, especially the spine. Being overweight [can also cause a back problem]. The more your frame has to support, the harder it works and the more susceptible to injury it becomes. Are women at higher risk for a painful back? Pregnancy definitely takes a toll. Postural changes put pressure on the spine. Ob-gyns say once you deliver it will go away. Well, sometimes it does, but [it can leave them] more vulnerable [to future back problems]. Plus, now they have kids to take care of. They’re bending and lifting all the time. It’s a breeding ground for back pain. What role does stress play with back trouble? It’s like putting lighter fluid on a fire. It might not cause back pain, but it certainly keeps it going. How does aging affect our backs? Gray hairs and wrinkled skin aren’t the only consequences of getting older. There are musculoskeletal changes – cellular, chemical and mechanical. Even if you don’t have a painful back, if you take an MRI you’ll probably see disk degeneration and some arthritis. What does disk degeneration look like? The disk is like a little jelly donut between each of your vertebrae. It keeps the bones from rubbing against each other. When you’re young, they’re bright and water-filled. With age, they start darkening and shrinking. It’s like grapes turning into raisins. They’re accidents waiting to happen. We’re the first generation to try to stay active all our lives, and we’re living longer. We’re pushing our bodies. So there’s an explosion of musculoskeletal problems. There’s a mismatch between longevity and durability. We weren’t designed to go as long as we’re going. Does that mean a back problem is inevitable? Changes in the body are inevitable, but problems aren’t. You can rebuild muscle at any age. Studies involving 90-year-olds found that after a 12-week strength-building program, strength improved dramatically. Those who had used walkers were able to get around with canes, and those who had used canes walked without them. What activities are best for back health? Being more fit aerobically protects against back pain. There was a famous study of firefighters on disability claims. The people who had the worst aerobic fitness were most likely to miss work from lower back problems. How does heart and lung fitness help your back? We’re not sure. It probably helps with microcirculation, the blood supply that nourishes the nooks and crannies of your musculoskeletal system. And it keeps your weight down. But cardiovascular fitness by itself it isn’t enough. What else can help prevent a back problem? Core strength is really important. That’s not just six-pack abs. It’s your back muscles, obliques [the muscles on the sides of your abdomen], the back extenders and the muscles of the pelvis. They’re the support structure around the spine. I recommend a routine that works out all of these muscles. The exercises should be done every other day. Many “core” exercises you recommend are based on yoga – for example, the cobra and cat poses. How does yoga prevent or relieve a back problem? Yoga is great for back strength, enhanced flexibility and learning to relax. Many people are competitive about exercise. They’re out there playing hard, trying to outdo everyone else. The nice thing about yoga is it’s not a competition. What other fitness disciplines do you like for backs? A lot of the martial arts, especially the soft styles like tai chi, are great for posture and strength. What are back-friendly options for an aerobic workout? Walking. Swimming is fantastic, even if you have an acute back episode or just a run-of-the-mill chronic backache. If you’re not a swimmer, or your lower back is just too sore for you to swim, try water walking, water jogging or even water aerobics. The water supports your body, and it’s a comforting environment if you have a painful back or back spasms. You can do things that might be too uncomfortable on land, with gravity working against you. Any nutritional advice to promote back health? Vitamin D deficiency is a much bigger deal than we thought. Some studies have linked it with back pain. I make sure all my patients, men and women, [get] enough vitamin D3 [the more absorbable form] and calcium. When people have really bad back pain, shouldn’t they just rest? The old days of bed rest are over. We usually suggest a day or two off your feet, if you need that, to get into positions that are more comfortable. After that, it’s counterproductive. Why? Motion is lotion! I see a lot of people who are on disability for life – they have sedentary jobs, they’re not digging or building things or using their backs for work. If you’re staying home, hooked on soap operas and taking pain medication, you’re not getting better. If all you can do is get in a pool and move around a little, you should do that. But people often worry that movement will aggravate the problem. You need to learn the difference between hurt and harm. Many lower back problems are so painful that people get frightened and assume that movement will harm them. It’s not true. If you can deal with the hurt and work around it, you [won’t] harm yourself or make things worse. Should you get a magnetic resonance imaging [MRI] scan to figure out what’s wrong? You probably don’t need one. I had an X-ray after I was tackled, but I’ve never had an MRI. I knew it wouldn’t change my treatment. Still, spine MRIs can be very helpful in cases of [severe,] chronic back pain or if there’s significant leg weakness or numbness. It’s best to talk to your doctor. Should people take painkillers for back pain? Narcotics can help in the very short term, but they can lead to secondary problems like addiction. I’ll reluctantly prescribe them for a few days if patients need them to get comfortable and move around. I prefer the over-the-counter pain meds such as NSAIDS [non-steroidal anti-inflammatory drugs, including Advil and Aleve] for short-term use. But [drugs] won’t solve a back problem. Is massage helpful? I’m a big fan of massage for pain relief. But it [won’t] cure anything – you shouldn’t rely only on passive modalities, in which someone else does all the work. If you get some relief from it, you should use that period of improvement to do things [that] make yourself better. What are those things? It’s a lifestyle change and an attitude. You have to create new habits and stay active. You have to have the right mindset. I can tell when I walk into [an examining] room [that] if the patient is stressed out or negative, it’s going to be impossible to get them out of their back pain. Remember, you are part of the solution to any health problem you face. For more expert advice and information, visit our Chronic Pain Health Center. How Bad Is Your Back Pain? So your back hurts? Take our back pain quiz to see how severe it really is. You may need to see a doctor but have just been avoiding it, thinking it will get better. On the other hand, your back pain may be more normal than you suspect.

8 Easy Ways to Lower Your Blood Pressure Take These Steps to Prevent Hypertension

High blood pressure is a dangerous condition that damages the heart, blood vessels and kidneys. It can be a time bomb waiting to go off. Fortunately, you can make a few simple lifestyle changes to lower your risk of this “silent killer” without sacrificing all your favorite foods. Read on for safe, natural ways to lower your blood pressure… If you have high blood pressure, you probably found out at your last doctor’s visit when you had that black band strapped around your upper arm. That’s because hypertension presents few symptoms. Normal blood pressure for women is 120/80 millimeters of mercury (mm Hg) or lower, according to the American Heart Association (AHA). Results of the test come as two numbers, with one over the other: Your “systolic pressure” (the top number) measures the pressure of your blood against the walls of your arteries when your heart beats. Your “diastolic pressure” measures between beats. If your reading is 121/81 mm or higher, you may be pre-hypertensive or hypertensive. So how do you get your numbers down? One option is medications, such as ACE (angiotensin-converting enzyme) inhibitors, which widen blood vessels. Then there are beta blockers, which slow heart rate. But lifestyle changes can make a big difference, whether your blood pressure is very high or just a bit elevated. “Diet and physical activity can lower blood pressure and may reduce or eliminate the need for medications by many patients,” says Nisa M. Maruthur, M.D., an assistant professor in the Division of General Internal Medicine at Johns Hopkins University School of Medicine in Baltimore, Md. Just shaving a few numbers leads to a big payoff. For example, lowering systolic blood pressure by just three points can reduce your risk of dying from heart disease by 5%, according to the AHA. (As you age, the systolic number becomes more important, because it’s the indicator of hypertension.) Here are 8 important ways to lower blood pressure naturally: 1. Make a DASH. The U.S. National Institutes of Health developed the DASH (Dietary Approaches to Stop Hypertension) diet to help Americans lower blood pressure. Following the DASH diet can lower systolic blood pressure by an average of 11.4 points and diastolic pressure by 5.5 points, studies show. And you reap rewards quickly: It can lower your blood pressure in as little as two weeks. The DASH diet is high in fiber, fruits and vegetables (8-10 servings daily) and low in saturated fat. It also includes fat-free or low-fat milk and dairy products, whole grains, fish, poultry and nuts. Lean red meat, sweets, added sugars and sugary drinks are allowed, but only in small quantities. Besides lowering blood pressure, the DASH diet also reduces total heart disease risk by 18%, according to a 2010 study in the journal Circulation: Cardiovascular Quality and Outcomes. For complete details, including meal plans and recipes, read Lower Cholesterol With the DASH Diet. 2. Check labels for salt. Americans consume an average of 4,000 milligrams (mg) of sodium (or 2 teaspoons of salt) daily, nearly twice the recommended amount for healthy people, and nearly three times what people with signs of high blood pressure should be getting. Hypertensive people should limit sodium intake to less than 1,500 mg (about 2/3 teaspoon of salt) a day, doctors advise. Blame salt’s ability to absorb liquids. “Salt or foods containing sodium draw fluid into your blood vessels and tissues,” says Kelly O’Connor, R.D., a registered dietitian at the Center for Endocrinology at Mercy Medical Center in Baltimore, Md. “The extra fluid can make your heart work harder,” she says. “As a result, your blood pressure gets higher.” A diet high in sodium also raises your risk for stomach cancer, kidney disease and osteoporosis. Although sodium occurs naturally in some foods, most of the salt in the American diet is added during food manufacturing and preparation. Besides checking the sodium content on nutrition labels, here are easy ways to cut sodium from your diet: Avoid fast food, which is often very high in sodium. Be on high alert for delicatessen meats, canned soups, packaged snacks, soy sauce, frozen dinners, salad dressings, marinades and bread, which all pack a lot of sodium. Stop adding salt to foods. At first, your meals may taste bland, but your palate will adjust, and you’ll eventually savor the taste of unsalted food. Use salt-free flavorings, such as herbs, spices, vinegars and citrus juices. Steer clear of MSG (monosodium glutamate), which, as its name implies, is high in salt. Ask your server at restaurants to prepare your meal without salt or soy sauce. 3. Pump up potassium. Besides eating too much sodium, Americans don’t eat enough potassium. This is a dangerous combination because potassium helps cut sodium’s effect on blood pressure by controlling the fluid balance in cells. Potassium also helps lower your blood pressure by relaxing arterial walls. You can take supplements, but getting potassium from food is better, says Keri M. Gans, R.D., a spokeswoman for the American Dietetic Association. “It’s best to get your nutrients from whole foods, because they contain a variety of micronutrients and phytochemicals that your body needs versus just one nutrient found in a single pill,” Gans explains. The DASH diet is high in potassium (as well as several other heart-healthy minerals). High-potassium foods include: Kidney beans Lentils Asparagus Mushrooms Avocados Oranges and orange juice Yogurt Cantaloupe Watermelon Prunes Potatoes 4. Work it out. If you have high blood pressure, exercise can lower it by up to 10 points (of systolic pressure), and 6-10 points diastolic, studies have found. Aerobic exercise – such as walking, jogging, cycling, stair climbing and anything else that gets your heart rate up – helps lower your blood pressure “by encouraging cells in the artery walls to produce chemicals that open the blood vessels,” explains cardiologist Stephanie Coulter, M.D., director of the Texas Heart Institute’s Center for Women’s Heart and Vascular Health in Houston. When arteries are open, blood flows easily throughout the body and the pressure is closer to normal. “It’s like when your garden hose gets pinched and water flows out under higher pressure in spurts, rather than freely,” Coulter says. Exercise can also magnify the effect of other lifestyle changes. For example, people who follow the DASH diet and exercise see a greater drop in blood pressure than those who follow the diet but remain sedentary. Experts recommend getting a minimum of 150 minutes per week – about 20 minutes a day – of moderate-to-vigorous aerobic exercise. 5. Stop smoking. Every time you smoke a cigarette, your blood pressure goes up temporarily because less oxygen gets to your heart. Over time, smoking narrows blood vessels, making it harder for blood to flow through them. That allows arteries to harden and become clogged with fat. “The toxins in cigarette smoke enter the body and damage the coronary arteries that bring blood to the heart,” says cardiologist Matthew Sorrentino, M.D., FAAC, an associate professor of medicine at the University of Chicago. "Cholesterol builds up on the arteries, and they become blocked, which can lead to a heart attack," While quitting can’t undo damage already caused by smoking, it offers almost immediate health benefits. “The risk of having a stroke or heart attack because of past smoking dissipates pretty quickly, within a year or two of quitting,” Sorrentino says. 6. Lose weight. Being overweight or obese raises blood pressure because excess fat can cause artery walls to stiffen, making them less flexible to changes in blood flow. Losing weight helps arteries become less stiff, allowing blood pressure to fall. Dropping just 10 pounds helps. In a large study published in the Archives of Internal Medicine in 2008, researchers found that losing as little as 9 pounds could reduce systolic pressure by an average of 6.3 points, and diastolic pressure by 3.4 points. 7. Limit alcohol. Drinking alcohol – beer, wine or spirits – can increase blood pressure. It can also increase the chance of developing other heart disease risk factors, such as high cholesterol, type 2 diabetes and weight gain. Because excessive drinking or binge drinking (4-5 servings of alcohol in under two hours) can dangerously spike blood pressure, it also boosts the likelihood of having a stroke. The AHA advises people to drink moderately, which means an average of one to two drinks per day for men and one drink per day for women. (A serving is 12 ounces of beer, 4 ounces of wine, 1.5 ounces of 80-proof spirits or 1 ounce of 100-proof spirits.) 8. Cut back on soda. Americans drink an average of 2.3 servings (28 ounces) of sugary drinks per day. But consuming fewer sugar-sweetened beverages can help lower blood pressure, according to research published in Circulation: Journal of the American Heart Association. Here’s why: The sugar in soda can cause insulin spikes that damage blood vessel walls. Cutting out one daily serving of soda, fruit punch, sweetened iced tea and other sugary drinks lowered blood pressure by about 2 points systolic and 1 point diastolic, according to the 2010 study, which looked at dieting overweight adults. Drinking sugary beverages also has been associated with an elevated risk of obesity, type 2 diabetes and metabolic syndrome, a combination of symptoms that boost heart disease risk.

Diabetes Diagnosis: A Game Changer for Randy Jackson How The ‘American Idol’ Judge Learned to Manage Diabetes

When “American Idol” judge Randy Jackson found himself tired and thirsty, he thought he just had the flu – but he ended up with a diabetes diagnosis instead. Now, the music producer, who says he didn't look after himself as he should have, is singing another tune to help others manage diabetes better... Nine years ago, Grammy Award-winning music producer and “American Idol” judge Randy Jackson was on top of the world. He was living large with a hit TV show, successful producing career and loving family – wife Erika Riker, daughter Zoe, 14, and son Jordan, 12. But he realized that something wasn’t right with his health. “I was perspiring all the time and couldn’t quite quench my thirst,” Jackson says. “I was very lethargic [and] started to get a little lightheaded every now and then.” When he couldn’t shake off those symptoms, he headed to an emergency room. That’s when he got a wake-up call: a diabetes diagnosis. Type 2 diabetes, a chronic metabolic disease in which the body can’t use blood sugar normally, affects nearly 26 million Americans. Many, like Jackson, don’t know they have it and postpone getting annual checkups or physicals. “I’d go to the doctor only when something was drastically wrong,” Jackson confesses. That all changed after his diabetes diagnosis. He started taking control of his health with a regimen that included losing weight, becoming active and paying daily attention to his blood sugar levels. Now, 114 pounds lighter, the “American Idol” judge is dedicated to leading a better lifestyle. In this Lifescript exclusive, Jackson shares his life-altering diabetes diagnosis, and explains why he opted for gastric bypass surgery to jump-start his weight-loss program. What symptoms made you realize you needed to see a doctor? I thought I had some kind of flu [or] cold … and thought, Well, I’ll take a couple days off, get some over-the-counter meds, maybe call the doctor [and] get some antibiotics or whatever people generally take when they have a cold or flu. About five days later, I wasn’t getting better and symptoms were increasing, so I went to the emergency room and found out I had type 2 diabetes. How did you feel once you heard the diabetes diagnosis? My doctors are pretty hard-core. They pull no punches. I like them that way. [They asked,] “What are you going to do? I’ve been telling you for years. Think about getting your health together. You’ve got a real serious disease that won’t go away. The great news is that you can manage diabetes. The bad news is that there’s no cure.” Was the diabetes diagnosis frightening? Yes – people [with diabetes] face a 2-4 times higher risk of developing heart disease and stroke. You’re supposed to go [to the doctor] every year for a checkup, but I would maybe make it every couple of years. So I really needed to get it together. There’s diabetes in your family. Did you think you were at risk of getting it? You never think it’s going to happen to you, even though it ran in my family. I really don’t think you’re that conscious of the risk. You’re always thinking about other things. There are brighter bulbs shining in your life than to worry about somebody’s health. Sometimes [life] has to knock you in the head and to the dirt for you to listen. What’s the goal of the “Taking Diabetes to Heart” campaign that you and Merck pharmaceutical company are involved with? We’re trying to raise awareness to help people better manage [diabetes]. I was talking to a buddy the other day who’s also type 2. I always say to him, “Man, how’s your blood sugar? What’s going on? Have you been checking it?” Those [diabetes] ABCs – A1C [test] of your blood sugar; B, blood pressure; and C for cholesterol – are vastly important with this disease. Weight is also an important factor in type 2 diabetes. After your diabetes diagnosis, did you try other weight-loss methods before having the Fobi Pouch gastric bypass surgery? [Yes.] I tried just a diet and exercise program, but things weren’t moving as fast as we needed them to move. My mother-in-law had amazing results [with gastric bypass surgery], so I thought, I need something to jump-start this. Gastric bypass isn’t a cure per se, but it’s a big jump-start in your weight loss. You still have to get your eating habits in order and continue to diet and exercise. You have to work out, so you don’t gain the weight back. We’ve seen a lot of instances where [overweight people] gain it right back. [Gastric bypass] isn’t a cure-all, trust me. Did you experience side effects after the surgery? There are side effects with the Fobi Pouch [in which a ring is placed around the upper portion of the stomach] – kind of like heartburn. After the surgery, did you feel ill if you ate bad food? It would make you not feel well to eat some of those foods, but your body would slowly adapt back to it, but taking in too many carbs is still bad for you. You were raised in the South, which is famous for fattening foods, like barbecue and fried chicken. Was it difficult to change your eating habits after your diabetes diagnosis? Growing up in the South with all the greasy fried foods – where every food that’s sweet is sweeter than the next, like the carrots are sweeter than cake – was a challenge. So you have to say no to barbecue, because the sauce alone will kill you – you’re talking about [large amounts of] sugar. It’s something like 50 grams per tablespoon. Then there’s all the fat in the meat. I couldn’t eat like that anymore. I had to get out, get active and start moving. The Fobi Pouch drops the weight to a certain degree, but you have to do what you can to maintain [the weight loss]. It’s the same thing you have to do to [manage] diabetes overall. How does a man from Louisiana give up barbecue? This is the way I equate it: I ate enough of that food for 100 people for 200 lifetimes. I can let it go. Sometimes abstinence is a good thing. I don’t need to go to the barbecue joint anymore, trust me. I don’t smoke anymore either. How much weight did you lose before you saw results in your health? I was up to 350 pounds, so by the time I lost 65 pounds, I started to see a dramatic change. I was in terrible shape – worst I’ve ever been in my entire life. Yet, wasn’t it also the best time of your life with the success of “American Idol”? I don’t know if there’s a best time of life in my world. All the times are great because you live and learn and, hopefully, evolve in the experience. To manage diabetes, you have to work out. What do you do for exercise? I do Pilates, yoga [and] play tennis about four times a week. I do some free weights and the treadmill. Do you need fun activities to stay motivated to exercise? That’s why I play tennis. I like being outdoors, playing a game. That way I don’t feel like I’m working out for two hours. If you go back to when you were a kid, that’s what you were doing. We’d be out 10-12 hours a day until the sun went down and my mom would have to beg us to come in for dinner. But people [with a diabetes diagnosis] should meet with their doctor to find the right plan for them, because no one size fits all. For me, this works. But somebody else may need to go to a big gym with a bunch of people with the headphones on. With such a busy schedule, how do you have time to take care of yourself? I have a lot of helpers. But you just have to get into a regime that works for you. You have to know when and how to alter [your schedule]. Time management is something everybody struggles with, and especially once you have kids, it becomes even more difficult. How many times a day do you check your blood sugar? I check 3-4 times a day routinely. Is it a big burden to check your levels that often? Yes, [but] it’s a disease you can manage. You’re not going to get rid of it. There’s no cure, but you definitely can manage [diabetes]. The website TakingDiabetestoHeart.com has a lot of great, helpful insights, some challenges and even some recipes. Do you take medication to manage diabetes? I take pills [that help control blood sugar levels] whenever I need them. That’s why I check [my blood sugar] all the time. You don’t have to inject yourself with insulin to manage your blood sugar levels? No, because if you get your diet and exercise together, you can usually curb a lot of those type of [treatments]. Does Merck make your medication? Not at all. We’re just [partnering] in an awareness program to help people manage [diabetes]. I applaud what we’re doing here, because half the people walking around winded don’t know they have it. Awareness is key. You’ve got to pay it forward – always.