In Full Stride
Health and Wellness
Alcohol and Health
What is at-risk drinking?
At-risk drinking means drinking more than seven drinks a week or three drinks on a single day. At-risk drinking also includes binge drinking.
For some women, drinking any amount of alcohol is at-risk drinking. These include women who are
For women, binge drinking is having more than three drinks per occasion. Binge drinking is a major problem among women in the United States. About one in eight women 18 years and older report binge drinking in the past 30 days. For girls younger than age 18, one in five report binge drinking.
Women and men react differently to alcohol. A chemical in the body that breaks down alcohol is less active in your body than it is in men’s bodies. This means that more of the alcohol that you drink enters your bloodstream. Women typically weigh less than men and have less body water, so the alcohol that you drink is not diluted as quickly as the alcohol a man drinks. You will become intoxicated more quickly and have a higher blood alcohol level than a man who drinks the same amount.
Regular at-risk drinking can lead to alcohol dependence (also called alcoholism). Women who are alcohol dependent keep using alcohol even when it causes problems with their health, safety, or relationships. Increased physical risks include the following:
The following signs and symptoms are associated with alcohol dependence:
Drinking alcohol during pregnancy is a leading cause of birth defects. Alcohol can harm a fetus throughout pregnancy. This includes the first few weeks before you know you are pregnant and during the last weeks of pregnancy when the fetal brain is maturing. Even moderate alcohol use during pregnancy can cause lifelong problems with a child’s learning and behavior. Any amount is risky for women who are pregnant or trying to become pregnant. All types of alcohol are harmful, including beer and wine.
Fetal alcohol spectrum disorders (FASDs) are health problems that can occur in a person whose mother drank alcohol during pregnancy.
The most severe FASD is fetal alcohol syndrome (FAS). FAS causes
For every child born with FAS, many more are born with other FASDs. These children may have problems with coordination, behavior, attention, learning, and understanding consequences without any of the physical signs of FAS.
Birth defects related to alcohol are 100% preventable by not drinking during pregnancy. Prevention involves these three steps:
Although it is true that no amount of alcohol use is safe during pregnancy, serious harm from this kind of use is unlikely. The important thing is to not drink any alcohol for the rest of the pregnancy.
Information from ACOG
BRCA 1 and BRCA 2 Mutations
What is cancer?
Normal cells in the body grow, divide, and are replaced on a routine basis. Sometimes, cells divide abnormally and begin to grow out of control. These cells may form growths or tumors. Tumors can be benign (not cancer) or malignant (cancer). Benign tumors do not spread to other body tissues. Cancer tumors can invade and destroy nearby healthy tissues, bones, and organs. Cancer cells also can spread to other parts of the body and form new cancerous areas.
Cancer is caused by several different factors. A few types of cancer run in families. These types are called “hereditary” or “familial” cancer. They are caused by changes in genes that can be passed from parent to child. Changes in genes are called mutations.
Hereditary breast and ovarian cancer (HBOC) syndrome is an inherited increased risk of breast cancer, ovarian cancer, and other types of cancer. HBOC syndrome is linked to mutations in several genes, but the most common are called BRCA1 and BRCA2.
BRCA1 and BRCA2 are tumor suppressor genes, which means that they keep cells from growing too rapidly. Everyone has these genes. Changes or mutations in these genes mean they do not work properly and cells can grow out of control, which can lead to cancer.
The risk of breast cancer for the average American woman is about 12% in her lifetime. Having a BRCA mutation greatly increases the risk. The estimated risk of breast cancer in women with a BRCA mutation is 45–85% by age 70 years.
The risk of ovarian cancer for the average American woman is about 2% in her lifetime. The estimated risk of ovarian cancer in women with a BRCA1 mutation is 39–46% by age 70 years. For women with a BRCA2 mutation, the risk of ovarian cancer by age 70 years is 10–27%.
Yes. Women who have a BRCA mutation also have an increased risk of cancer of the fallopian tube, peritoneum, pancreas, and skin (melanoma). Men who have a BRCA mutation have an increased risk of cancer of the breast, prostate, and pancreas.
About 1 in 300 people to 1 in 800 people carry a BRCA1 or BRCA2 mutation. Anyone can have these mutations, but they are found more often in certain ethnic groups. These groups include people of the following backgrounds:
Your obstetrician–gynecologist (ob-gyn) or other health care professional should ask you questions about your personal and family history of breast cancer and ovarian cancer. The questions may include the following:
If your answers to these or other questions suggest that you may have a BRCA mutation, genetic counseling and testing may be offered.
Before you have genetic testing, a genetic counselor or a physician who specializes in inherited types of cancer can help you understand how the testing is done, what the results may mean, and what you may do depending on the test results.
BRCA testing is only recommended for people with a high risk of having BRCA mutations. It is important to remember that most cases of breast and ovarian cancer are not caused by gene mutations. If there is a low chance of finding a BRCAmutation, your ob-gyn or other health care professional may not recommend genetic testing.
Genetic testing requires a sample of blood or saliva. There are several ways that testing can be done:
A negative test result can mean several things:
An unclear test result means there is a change in a BRCA gene, but it is not known whether the change increases the risk of cancer. Researchers continue to study BRCA and other genes to find out how they may influence cancer risk. If you have an unclear result, a genetic counselor can explain strategies that may reduce your risk.
A positive test result means you have a BRCA mutation for which you have been tested. That means you have an increased risk of getting cancer. It does not mean you will get cancer. There is no test that can tell which women with a BRCA mutation will develop cancer or at what age. It is important to discuss your results with your genetic counselor and learn what you can do to decrease your risk of cancer.
Having a BRCA mutation means you can pass the mutation to your children. Your siblings also may have the gene mutation. You are not obligated to tell your family members, but sharing the information could be life-saving for them. With this information, your family members can decide whether to be tested and get cancer screenings at an early age.
If you test positive for a BRCA mutation, you may discuss prevention options with your ob-gyn, genetic counselor, or other health care professional. Prevention includes screening tests, medications, and surgery.
Breast cancer screening may include the following tests for women with BRCA mutations:
Currently there is no recommended screening test for ovarian cancer for average-risk patients. For high-risk patients, one ovarian cancer screening method that has been studied is a blood test that measures levels of a marker called CA 125. A marker is a substance made by cancer cells. Levels of CA 125 sometimes are increased in women with ovarian cancer. An ultrasound exam of the ovaries also may be recommended for women with a BRCA mutation. If your ob-gyn or other health care professional recommends these tests, you may begin testing between the ages of 30 years and 35 years.
It is important to know that these screening tests have a limited ability to find ovarian cancer at an early, more treatable stage. Test results may be normal even when cancer is present. There also is a high rate of false-positive results (a positive test result in someone who does not have ovarian cancer). There are ongoing studies to find an accurate and reliable screening test for ovarian cancer.
A medication called tamoxifen has been shown to reduce the risk of breast cancer in women with BRCA2 mutations. Tamoxifen is a drug that blocks the effects of estrogen on cancer cells that respond to this hormone.
Tamoxifen works better in women with BRCA2 mutations because most breast cancer tumors in this group grow in response to estrogen. Tamoxifen does not appear to reduce breast cancer risk in women with BRCA1 mutations because fewer cancer tumors in this group respond to estrogen.
Combined hormonal birth control pills (those that contain estrogen and progestin) have been shown to reduce the risk of ovarian cancer. The longer a woman takes the pill, the more the risk is reduced—for every 5 years on the pill, a woman reduces her risk by about 20%. But this benefit needs to be balanced against the risks of using the pill. The pill is safe for most women, but it is associated with a small increased risk of deep vein thrombosis (DVT), heart attack, and stroke. Your ob-gyn or other health care professional can help you understand how to balance the benefits and risks of using the pill.
Yes. Surgical removal of both breasts is called risk-reducing bilateral mastectomy. It can reduce the risk of breast cancer by 85–100% in women with a BRCA mutation. Total mastectomy, in which all breast tissue is removed, including the nipple, is the most effective surgery for reducing the risk of breast cancer. Mastectomy that removes the breast tissue and leaves the nipple also can be considered and is very effective. Some women choose to have breast reconstruction after a mastectomy.
Side effects of a mastectomy can include the following:
Yes. The removal of both ovaries and both fallopian tubes is called risk-reducing bilateral salpingo-oophorectomy. In women with a BRCA mutation, this surgery can reduce the risk of ovarian cancer by about 80%. The surgery also reduces the risk of cancer of the fallopian tubes and peritoneum. If it is done before menopause, this surgery also can reduce the risk of breast cancer. Women with a BRCA mutation should consider this surgery between the ages of 35 years and 40 years or after they have completed childbearing. Some women may be able to delay slightly longer. Removal of the ovaries means you will not be able to get pregnant.
Researchers also are studying the removal of only the fallopian tubes (salpingectomy) to prevent ovarian cancer. Some cases of ovarian cancer may start in the fallopian tubes, so removing the tubes may help prevent ovarian cancer without putting a woman into menopause. More research is needed in this area.
Removal of the ovaries before menopause will cause you to go through menopause immediately. This is called surgical menopause. Symptoms may be more severe than if you were to go through menopause naturally over several years. Menopause symptoms often can be managed with hormone therapy and other treatments. You can discuss these treatment options with your ob-gyn or other health care professional before your surgery.
If you are thinking about having preventive surgery, you and your ob-gyn or other health care professional will discuss the risks and benefits. You should consider the psychological effects as well as short- and long-term complications. Timing of surgery should be based on your cancer risk, your desire to have children, and the effect that surgery will have on your well-being.
Many people are concerned about possible employment discrimination or denial of insurance coverage based on genetic testing results. The Genetic Information Nondiscrimination Act of 2008 (GINA) makes it illegal for health insurers to require genetic testing results or use results to make decisions about coverage, rates, or preexisting conditions. GINA also makes it illegal for employers to discriminate against employees or applicants because of genetic information. GINA does not apply to life insurance, long-term care insurance, or disability insurance.
A direct-to-consumer genetic test is a genetic test that you can order over the internet. You do not need a doctor’s order for it. The American College of Obstetricians and Gynecologists discourages use of direct-to-consumer genetic tests because the results may be misleading. For example, one test for BRCA mutations only looks for three mutations, even though there are more than 500 BRCA mutations linked to cancer. The test results could cause unnecessary fear, or a false sense that you are not at risk. You should always see a health care professional if you want a genetic test.
Information from ACOG
Cholesterol and Heart Health
What is cholesterol?
Cholesterol is a fatty, wax-like substance. Your body uses cholesterol to make the outer coverings of cells. Cholesterol is a part of certain hormones, including estrogen and testosterone. It also helps your body make vitamin D and produces the bile that helps you digest food.
The liver makes most of the cholesterol in your body. A small amount comes from foods, such as meat and dairy products. The fat in these foods is turned into triglycerides. Triglycerides travel through the bloodstream and are stored in fat cells as a source of energy. The body also converts sugars in fruits and sugary foods into triglycerides.
In the body, cholesterol is packaged with a protein and triglycerides into a substance called a lipoprotein. There are two main types of lipoproteins:
Having abnormal levels of cholesterol or triglycerides is called dyslipidemia. A common dyslipidemia in the United States is having an LDL cholesterol level that is too high, an HDL cholesterol level that is too low, and elevated levels of triglycerides. This type of dyslipidemia increases the risk of cardiovascular disease.
When the level of LDL is high, it can collect inside the walls of blood vessels. When the level of HDL is low, there may not be enough available to remove the “bad cholesterol” from the blood vessels. LDL within the walls of blood vessels triggers a response by the body’s immune system. Eventually, this immune response can lead to a buildup of a substance called plaque in the blood vessels. Plaque can narrow and harden the arteries, a condition called atherosclerosis.
Over time, plaque can develop into a blood clot that narrows or blocks the flow of blood in an artery. If this occurs in an artery in the heart, it can cause a heart attack. If this occurs in an artery in the brain, it can cause a stroke.
Other risk factors are advancing age, male sex, family history, smoking, physical inactivity, obesity, a poor diet, and medical conditions such as diabetes mellitus and high blood pressure.
Polycystic ovary syndrome, high blood pressure disorders that occur during pregnancy, and gestational diabetes are all risk factors for cardiovascular disease that are unique to women.
A simple blood test can show if your cholesterol levels are healthy. A complete lipoprotein analysis measures the levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.
Women without risk factors should have their cholesterol levels measured every 5 years beginning at age 45 years. Women who have risk factors for cardiovascular disease may need to start cholesterol screening earlier.
The following changes may reduce your risk of cardiovascular disease:
Statins are drugs that cause the liver to make less cholesterol. In addition to lowering LDL levels, they also may help decrease the levels of triglycerides and increase levels of HDL.
Information from ACOG
High Blood Pressure
What is blood pressure?
Blood pressure is the force of blood pushing against the walls of the blood vessels called arteries. The arteries carry blood from your heart to your lungs, where the blood picks up oxygen, which is delivered to your organs and tissues. The organs and tissues use the oxygen to power their activities. Other blood vessels called veins bring the now oxygen-poor blood and waste products back to the heart and lungs.
You should have your blood pressure measured at least every 2 years if your blood pressure is normal and more often if it is higher than normal.
A cuff with a balloon inside is wrapped around your upper arm. Air is pumped into the balloon. Your pressure reading is taken while the cuff is squeezing your arm.
Your blood pressure reading has two numbers. Each number is separated by a slash: 110/80, for instance. You may hear this referred to as “110 over 80.” The first number is the pressure against the artery walls when the heart contracts. This is called the systolic blood pressure. The second number is the pressure against the artery walls when the heart relaxes between contractions. This is called the diastolic blood pressure.
Blood pressure can go up and down. It goes down when you sleep and goes up when you are active or nervous. This is normal. Your blood pressure is the average of several readings taken on different occasions.
Your blood pressure reading is classified into one of four categories: normal, prehypertension, stage 1 hypertension, or stage 2 hypertension. People who have prehypertension have twice the risk of developing hypertension compared with those who have normal blood pressure. Recognizing prehypertension is important. If you have prehypertension, you often can make lifestyle changes to prevent the development of high blood pressure.
Long before high blood pressure causes symptoms, it can damage vital organs in your body:
The following factors that increase the risk of high blood pressure cannot be changed:
Lifestyle habits also can affect blood pressure. These are things you can change. You are at greater risk of high blood pressure if you
Adopting certain lifestyle habits can decrease your risk of developing high blood pressure in the future:
If lifestyle changes alone do not lower your blood pressure, medications usually are recommended. Many types of medications are available that work in different ways. It is important to continue taking your medication even when you are feeling healthy. It also is important to continue your healthy lifestyle habits even if taking medication lowers your blood pressure readings into the healthy range.
High blood pressure during pregnancy can cause serious problems, including growth problems with the baby, preterm birth, and worsening of any preexisting conditions that you have because of high blood pressure. If you have chronic (long-lasting) high blood pressure and are planning to become pregnant, see your health care provider for a prepregnancy check-up. This will give you a chance to stabilize your blood pressure and to become as healthy as possible. During pregnancy, your blood pressure will be measured often. You will be monitored for signs and symptoms of preeclampsia. You may have special tests to monitor the well-being and growth of the fetus.
High blood pressure that first occurs in the second half (after 20 weeks) of pregnancy is called gestational hypertension. Management depends on how high your blood pressure is. Most women with gestational hypertension have only a mild increase in blood pressure. Some women, however, develop severe hypertension and are at risk of serious complications. All women with gestational hypertension are monitored closely to make sure their blood pressure does not go too high and to look for signs of preeclampsia.
Preeclampsia is a serious high blood pressure disorder that can occur during pregnancy and in the weeks after pregnancy. If it is not diagnosed and managed, it can cause severe complications in both the woman and her baby. Women who have had preeclampsia have an increased risk of developing high blood pressure and cardiovascular disease later in life.
Some birth control methods are not recommended for women with high blood pressure. These methods include the following:
Blood pressure usually does not change much with hormone therapy. In some women, hormone therapy actually decreases blood pressure. In others, some types of hormone therapy increase blood pressure. Because the effects of hormone therapy on blood pressure are not predictable, all women who are taking hormone therapy should have their blood pressure checked more often.
Information from ACOG
Deep Vein Thrombosis (DVT)
What is deep vein thrombosis (DVT)?
Deep vein thrombosis is a condition in which blood clots (or thrombi) form in deep veins in the legs or other areas of the body. Veins are the blood vessels that carry blood from the body’s tissues to the heart. Deep veins are located deep in the body, away from the skin’s surface.
Clotting is a normal process that helps stop bleeding, such as from a cut in the skin. A clot also can form if
When a clot forms in a deep vein, blood flow in the vein slows down and causes the vein to swell. If a piece of a clot breaks free and moves through the blood vessels to the lungs, it is very serious. This condition, called pulmonary embolism (PE), can be fatal. Nearly one third of people who have DVT develop PE. It is important to find and treat DVT early in order to prevent PE.
DVT can occur in anyone, but some factors can increase the risk. Having more than one risk factor further increases the risk. Events or conditions that increase the risk of DVT include the following:
Your doctor may prescribe medications to prevent blood clots from forming before or after surgery. You also may be told to stop taking certain medications before surgery. At the hospital, you may wear special elastic stockings or inflatable boots. These devices squeeze the muscles to help keep blood flowing. You may need to wear them until you leave the hospital. You may be urged to get up and walk around soon after the procedure. Your feet or the foot of your bed may be raised.
If you are pregnant, medication or other treatments may be prescribed to prevent DVT if you have certain risk factors:
If medication is prescribed for you, your health care provider will make sure you know how to take the medication and what you should avoid while taking it.
When planning a long trip, the following preventive steps are recommended, especially if you are pregnant or have other risk factors for DVT:
Only about one half of people who have DVT show any signs or have symptoms. Signs and symptoms of DVT in the ankle, calf, or thigh include
PE can be life-threatening. If you have any of the following signs or symptoms, you should contact your health care provider or go to the emergency room:
- A sudden cough, which may produce blood
- Sudden shortness of breath
- Pain in the ribs when breathing
- Sharp chest pain under the breast or on one side
- Burning, aching, or dull heavy feeling in the chest
- Rapid breathing
- Rapid heart rate
The following tests are used to diagnose DVT:
Other tests may be done if the clot is thought to be in the lungs:
DVT is most often treated with medications. Drugs may include anticoagulants to prevent clots or, less commonly, thrombolytics to dissolve them.
Information from ACOG
What is depression?
Depression is a common but serious illness. It is more than just feeling sad or upset for a short time or feeling grief after a loss. Depression changes your thoughts, feelings, behavior, and physical health. It can affect how you relate to your family, friends, and coworkers. It can occur at different times of life or in different situations. It also can occur as part of other disorders.
Depression causes a mix of emotional and physical symptoms. You have depression if you have five of the following symptoms most of the day, every day, during the same 2-week period. One of the symptoms must be either sad or depressed mood or loss of interest or pleasure in previously enjoyed activities:
Depression can be mild, moderate, or severe. If you have mild depression, it may take extra effort to do what you have to do, but often you can still do those things. With moderate depression, you may not be able to do some of the things you need to do. If you have severe depression, you may not be able to do any of the daily tasks you need to do.
Researchers do not know for certain what causes depression. They do know that depression is a brain disorder in which the parts of the brain that control mood, sleep, and thinking are not functioning properly. Depression may be caused by an imbalance in certain chemicals in the brain.
Factors that increase the risk of depression include the following:
To diagnose your depression, your health care provider will discuss your symptoms, how often they occur, and how severe they are. You also will be asked about your medical history, any medications you are taking, and whether you use drugs or drink alcohol. Certain medications and health conditions, such as an infection or a thyroid disorder, can cause symptoms similar to depression.
Depression is treated with psychotherapy, medications called antidepressants, or both.
In psychotherapy or “talk therapy,” a therapist will work with you to identify problems and suggest ways you might change your behavior to help relieve your symptoms.
You may have one-on-one therapy (with just you and the therapist) or group therapy where you meet with a therapist and other people with problems similar to yours. Another option is family or couples therapy, in which you and family members or your partner may work with a therapist.
Antidepressants are medications that work to balance the chemicals in the brain that control your moods. There are many types of antidepressants. If one type does not work for you, your health care provider can prescribe another. Drugs often can be combined. It may take some time to find the drug or combination of drugs that works best for you. It often takes at least 3–4 weeks of taking the medication before you start to feel better.
Antidepressants can cause side effects; however, most are temporary and go away after a short time. Listed are some of the most common side effects:
In teenagers and young adults taking certain kinds of antidepressants, the risk of suicidal thoughts and actions is increased. Close monitoring by a health care provider is necessary while taking these medications.
Some people believe that certain herbal supplements, such as the plant St. John’s wort, are effective in treating depression. Research has shown that St. John’s wort does not work for treating major depression. It even can be harmful because it can make some medications, including those taken to treat heart disease, seizures, and certain types of cancer, not work as they should. St. John’s wort also can make birth control pills not work as well.
Information from ACOG
What is diabetes?
Diabetes is a disease in which the body does not make enough insulin or does not use it as it should. Insulin is a hormone that helps balance the amount of glucose in your blood.
Normally, your body changes most of the food you eat into glucose. Glucose is then carried to the body’s cells with the help of insulin. If your body does not make enough insulin, or the insulin does not work as it should, the glucose cannot enter the body’s cells. Instead, it stays in the blood. This makes your blood glucose level too high.
There are two types of diabetes: type 1 and type 2. A person with type 1 diabetes needs to take insulin to survive because the body makes little or no insulin on its own. In people with type 2 diabetes, insulin is produced, but it does not work as it should. The body becomes resistant to the effects of insulin and produces more insulin to keep glucose levels normal. Over time, the body cannot maintain high enough levels to keep the glucose levels normal, and diabetes occurs. Type 2 diabetes also may occur as a result of other diseases or as a side effect of certain medications.
People with type 2 diabetes may not need to take insulin. They may be able to control their glucose levels with proper diet, medication, or both.
Diabetes may run in families or be linked to certain lifestyle factors. You should be tested if you have any of these risk factors:
The symptoms of type 1 and type 2 diabetes are listed as follows:
Type 1 diabetes
There are three types of tests used to diagnose diabetes:
If diabetes is not controlled, long-term, severe health problems may occur:
If you have diabetes, preparing for pregnancy can improve your health and that of your future child. Plan to see your health care provider before you get pregnant to discuss your care. You should try to have good control over your glucose level a number of weeks before you become pregnant. Your health care provider may suggest changes in your care that will help lower your glucose to a normal range.
To help prevent diabetes, follow a healthy diet and get regular exercise. This also can help keep your weight down—a key part of preventing diabetes. The following steps can help prevent the disease:
Information from ACOG
DIgestive Tract Issues
What are some common digestive problems?
Common digestive problems include the following:
Most common digestive problems are short term and easy to control with lifestyle changes and sometimes medication. In some cases, these problems can be a sign of more serious medical problems.
Constipation involves having fewer than three bowel movements a week. Stools may be firm or hard to pass. Swelling or bloating of the abdomen may occur.
Common causes of constipation include not eating enough fiber, not drinking enough water, certain medications, and changes in routine (such as travel). Constipation can occur during pregnancy. The increased levels of hormones during pregnancy can slow down the digestive system.
If constipation continues, your health care provider may suggest a laxative. Most of these products are available without a prescription.
Different types of laxatives work in different ways:
You can help prevent constipation by
Diarrhea is having three or more loose bowel movements a day. Cramping also may occur.
Several things can cause diarrhea:
If you have diarrhea, drink plenty of fluids to replace those that are lost. If diarrhea does not go away in a few hours, drink fluids and liquid foods that contain salt, such as sports drinks or broth. Avoid drinking dairy products, soda, and juices.
They may contain lactose, caffeine, or sugar, which may make diarrhea worse. Over-the-counter anti-diarrheal medications can be helpful. However, they should not be taken if you have a high fever or bloody diarrhea, which can be signs of a bacterial infection.
If diarrhea lasts more than 2 days, see your health care provider. Also see your health care provider if your stools contain blood or pus or if you have a fever, severe abdominal pain, or signs of dehydration (thirst, dry skin, fatigue, dizziness, less frequent urination, or dark-colored urine).
If you use birth control pills, diarrhea or vomiting may decrease their effectiveness. Call your health care provider about what to do if you have vomiting or diarrhea that lasts for 48 hours or more after taking a combined birth control pill or that lasts for 3 hours or more after taking a progestin-only pill.
Acid reflux occurs when the muscle in your esophagus that opens and closes when you swallow does not work properly. When this happens, food and digestive fluids, which contain acid, back up into your esophagus. Acid reflux can cause a burning feeling in your chest and throat, which sometimes is called heartburn.
You can control or even prevent acid reflux by taking these steps:
Several over-the-counter medications are available that may help reduce your symptoms. Antacids reduce the acid content in the stomach. Other medications stop the digestive system from making too much acid. Some of these medications are available over the counter.
If acid reflux occurs more than twice a week, or if you have been taking over-the-counter medications for more than 2 weeks with no relief, you may have a condition called gastroesophageal reflux disease (GERD). Treatment includes lifestyle changes and medication. Surgery also is used to treat GERD in some cases. GERD that is not treated can lead to complications, including ulcers in the esophagus, narrowing of the esophagus, and a precancerous condition called Barrett esophagus. If you have GERD, it is important to see your health care provider regularly for treatment and follow-up.
Hemorrhoids are swollen blood vessels in and around the anus and lower rectum. They can become painful, itchy, and irritated.
Hemorrhoids can result from several factors:
The symptoms of hemorrhoids can be relieved with ice packs to reduce swelling. Sitting in a bath of warm water may relieve symptoms. You also may use a hemorrhoid cream or suppositories. Surgery may be needed to remove hemorrhoids in some cases. Adding fiber and fluids to your diet can help prevent hemorrhoids.
Common digestive disorders include the following:
These disorders affect more women than men. They can last for weeks or months, although symptoms can come and go.
Irritable bowel syndrome mainly affects women between the ages of 30 years and 50 years. Symptoms of irritable bowel syndrome may include the following:
IBS cannot be cured, but it can be managed to reduce the symptoms. Changes in your diet, such as eating frequent small meals rather than two or three large meals a day and adding fiber to your diet, may help. Your health care provider also may suggest medications to relieve the symptoms.
People with celiac disease cannot tolerate gluten. Gluten is a protein found naturally in wheat, rye, and barley. When gluten is eaten, the immune system reacts by damaging the lining of the small intestine. As a result of this damage, nutrients cannot be absorbed properly. Some people with celiac disease have no symptoms. Others may have diarrhea, constipation, fatigue, or abdominal pain and bloating. If it is not treated, the disease can increase the risk of serious health problems, including osteoporosis, anemia, and cancer. Treatment involves avoiding gluten in your diet.
Colorectal cancer is cancer of the rectum and colon. It often begins as a polyp—a tissue growth in the colon or rectum. Routine screening can help prevent colon cancer. Polyps that are found during routine screening can be removed easily before they become cancerous.
If you are at average risk of colon cancer, the preferred screening method is a colonoscopy performed every 10 years beginning at age 50 years. A colonoscopy is an exam of the entire colon using a small, lighted instrument called a colonoscope. It is recommended that you stop having colonoscopy screening if you are older than 75 years. Screening with colonoscopy for people at high risk should begin at age 40 years or at 10 years younger than the age when the youngest affected relative received the diagnosis.
You are at high risk of colon cancer if you
Colorectal cancer usually shows no signs in the early stages of the disease. In the more advanced stages, signs and symptoms may include the following:
Having these symptoms does not mean that you have cancer. The same symptoms can result from other digestive disorders. Talk to your health care provider if you have any of these symptoms.
Information from ACOG
Sleep and Health
Sleep affects your mental and physical health. Getting good sleep helps boost your mind and mood and can help prevent health problems. Women are more likely than men to have insomnia and other sleep problems.1 Changing hormones during the menstrual cycle, pregnancy, and menopause can affect how well a woman sleeps. But there are steps you can take to get the rest you need.
How does sleep affect my mental health?
Your mind and body are healthier when you sleep well. Your body needs time every day to rest and heal. Some sleep disorders, such as insomnia, sleep apnea, and restless leg syndrome, make it harder to fall asleep or stay asleep. This can lead to daytime sleepiness and make it more difficult to stay in good mental health.
Having a sleep problem can also trigger a mental health condition or make current mental health conditions worse. Also, mental health conditions or treatments can sometimes cause sleep problems.
How much sleep do women need each night?
Most adults need between 7 and 9 hours of sleep a night to feel refreshed, although women who are pregnant may need more and older adults may average less.
What sleep problems affect women?
Sleep problems that affect women more or differently from men include:
- Insomnia. More than 1 in 4 women in the United States experience insomnia, or the inability to fall asleep or stay asleep. Insomnia is also more common in people with depression and anxiety, which also affect more women than men.
- Restless leg syndrome. More women than men experience restless leg syndrome. It can happen to women of all ages, but it happens most often during pregnancy. Also, some medicines used to treat depression can cause restless leg syndrome. Depression is more likely to affect women compared to men.
- Sleep apnea. Sleep apnea may be underdiagnosed in women. Snoring is one of the main signs of sleep apnea. Women with sleep apnea may be underdiagnosed, because they usually report more general symptoms, such as insomnia, anxiety, and nightmares.
Why do women have more sleep problems?
Women may be more likely to have sleep problems because women experience hormonal changes during certain times and events that are unique to women. These include:
- Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Women with PMS commonly report trouble sleeping. Nearly 7 in 10 women with PMDD say they have problems going to sleep and staying asleep in the days leading up to their period.
- Pregnancy, especially in the third trimester, when women may wake up more often than usual because of discomfort, leg cramps, or needing to use the bathroom.
- Perimenopause, when hot flashes and night sweats often can disturb sleep. Also, about half of women report problems sleeping after menopause.
How do I know if I have a sleep disorder?
Talk to your doctor if:
- You often have difficulty sleeping and the sleeping tips are not working for you
- You awaken during the night gasping for breath
- Your partner says that your breathing stops when you are sleeping
- Your partner says that your legs move rapidly during sleep
- You snore loudly
- You have to get up more than twice during the night to urinate
- You wake up feeling like you haven’t slept or are exhausted
- You fall asleep often during the day
How are sleep disorders diagnosed?
To determine whether your sleep problems are caused by a sleep disorder or another mental or physical health problem, your doctor will ask you questions about your medical and sleep history. Sometimes it can take several visits to a doctor to figure out the cause of your sleep problems.
Your doctor or nurse may:
- Ask about any new or ongoing health problems or stress.
- Ask about your sleep habits. Consider keeping a sleep diary for 1 or 2 weeks before you see your doctor. Write down when you go to sleep, wake up, and take naps.11 Keep track of how long you sleep each night and you how feel throughout the day. Some free apps for your mobile phone may also help you track sleep.
- Do a physical exam. This can help your doctor rule out other medical problems that might cause sleep problems. You might need blood tests to check for thyroid problems or other health problems.
- Recommend a sleep study. If your doctor thinks a sleep disorder is causing your sleep problems, you may be asked to do a sleep study. Sleep studies may record brain activity, eye movements, heart rate, and breathing patterns while you stay overnight at a sleep center. A study can also record how much oxygen is in your blood and how much air moves through your nose while you breathe, as well as your snoring and other measurements.
Can I take an over-the-counter (OTC) medicine to help me sleep?
Yes, but talk to your doctor or nurse about your sleep problems before using an OTC product. Your sleep problem may be a symptom of a different medical problem that needs to be treated. Also, OTC products are not meant for regular or long-term use. If you decide to use a sleep medicine, doctors recommend that you:
- Read the medicine label and directions first.
- Use the medicine at the time of day directed by your doctor or nurse.
- Do not drive or do activities that require you to be alert.
- Always take only the amount your doctor or nurse tells you to take.
- Tell your doctor or nurse about other medicines you use.
- Call your doctor or nurse right away if you have any problems while using the medicine.
- Do not drink alcohol or use drugs.
- Talk to your doctor or nurse if you want to stop using the sleep medicine. Some medicines must be stopped gradually.
What can I try at home to help me sleep better?
Try these tips to help improve your sleep:
- Try to go to sleep when you feel sleepy and then get up at the same time each morning.
- Do not take naps after 3 p.m. if you normally sleep at night.
- Do not drink caffeinated or alcoholic drinks or smoke late in the day or at night.
- Exercise on most days. Exercise or physical activity done too close to bedtime can make it harder to fall asleep. Experts recommend exercising at least 5 or 6 hours before your bedtime, especially if you have insomnia.
- Do not eat or drink a lot within about 3 hours of bedtime.
- Keep your bedroom dark, quiet, and cool. If light is a problem, try a sleeping mask. If noise is a problem, try earplugs, a fan, or a “white noise” machine to cover up the sounds.
- Follow a routine to help relax and wind down before sleep, such as reading a book, listening to music, or taking a bath.
- If you cannot sleep within 20 minutes of going to bed or don’t feel drowsy, get out of bed. Read or do a quiet activity until you feel sleepy. Then try going back to bed.
- Do not do anything in your bed that could make you more awake. Using a mobile phone, watching TV, or eating in bed can make it harder for you to fall asleep in bed.
- Do not look at lighted screens like a laptop or smartphone before bed.
- See your doctor or a sleep specialist if you think that you have a sleep problem.
Information from womenshealth.org
What is thyroid disease?
The thyroid gland is located at the base of your neck in front of your trachea (or windpipe). The thyroid gland makes, stores, and releases two hormones—T4 (thyroxine) and T3 (triiodothyronine). Certain disorders can cause the thyroid gland to make too much or too little hormone. Women at risk of thyroid disease include those who have or have had an autoimmune disease (such as diabetes).
Thyroid hormones control your metabolism, which is the rate at which every part of your body works. When your thyroid gland is working the way it should, your metabolism stays at a steady pace—not too fast or not too slow.
The thyroid gland is controlled by the pituitary gland (a gland in your brain). The pituitary gland makes thyroid-stimulating hormone (TSH). TSH tells the thyroid gland to make more hormone if needed.
Thyroid disease is diagnosed by your symptoms, an exam, and tests. Symptoms of thyroid disease can be much like symptoms of other health problems.
Your health care provider will examine your neck while you swallow. The thyroid gland moves when you swallow. This makes it easier for your health care provider to feel. Your health care provider also may examine your skin and eyes and check your weight and temperature.
The following tests may be used to help find the exact cause of a thyroid problem:
During a thyroid scan, you drink a small amount of radioactive iodine. A special camera then detects the areas of the thyroid gland that absorb the radioactive iodine. Results of this test show areas of the thyroid gland that are underactive or overactive. This test will not be done if you are pregnant.
Hypothyroidism occurs when the thyroid gland does not make enough of the thyroid hormones to maintain your normal body metabolism.
The most common cause of hypothyroidism is a disorder known as thyroiditis—an inflammation of the thyroid gland. The most common type of thyroiditis is called Hashimoto disease. In this disease, the immune system—your body’s natural defense against disease—mistakes cells in the thyroid gland for harmful invaders. Your body sends out white blood cells to destroy the thyroid gland. The pituitary gland then releases TSH to tell the thyroid gland to make more thyroid hormone. This demand on the thyroid gland can cause it to enlarge. This enlargement is called a goiter. Hypothyroidism also can result from a diet that does not have enough iodine, although this type of hypothyroidism is rare in the United States.
The symptoms of hypothyroidism are slow to develop. Common symptoms of hypothyroidism include the following:
In most cases, hypothyroidism is treated with medication that contains thyroid hormone. The dosage of the medication is increased slowly until a normal level of thyroid hormone has been reached in the blood.
Hyperthyroidism results when the thyroid gland makes too much thyroid hormone. This causes your metabolism to speed up.
The most common cause of hyperthyroidism is a disorder known as Graves disease. It most often affects women between the ages of 20 years and 40 years. A late sign of Graves disease is often a wide-eyed stare or bulging eyes.
Hyperthyroidism also may result from medication. Taking too much thyroid hormone when being treated for hypo-thyroidism can lead to symptoms of an overactive thyroid. Lumps in the thyroid called hot nodules are another cause. These lumps produce excess thyroid hormone.
Common symptoms of hyperthyroidism include the following:
Anti-thyroid medication can be used to reduce the amount of thyroid hormone your body is making. Medications known as beta-blockers control rapid heart beat.
If these medications do not help, your health care provider may suggest treatment with high-dose radioactive iodine to destroy parts of the thyroid gland. In some cases, surgery may be needed to remove the thyroid gland.
A nodule is a lump in the thyroid gland. When a thyroid nodule is found, it will be checked to see if it is benign (not cancer) or malignant (cancer).
Your health care provider may use ultrasound to examine the nodule. Nodules may be further examined by a procedure known as fine needle aspiration or biopsy.
If no cancer cells are found, your health care provider may either prescribe medication to decrease the size of your nodule or suggest surgery to remove it. If cancer cells are found, further treatment will be needed. Thyroid cancer usually can be treated with success.
Many medications used to treat thyroid disease in pregnancy are safe for your unborn child. However, your health care provider may monitor you closely while you are being treated. Radioactive iodine, which is sometimes used to treat hyperthyroidism, cannot be taken during pregnancy. It may injure the thyroid gland of the fetus and may cause the baby to have hypothyroidism.
Some women may not have thyroid problems during pregnancy, but develop problems after childbirth. This condition is called postpartum thyroiditis. It often is a short-term problem and hormone levels quickly return to normal.
Regular screening for thyroid disease should be done every 5 years beginning at age 50 years. Women at risk may need to be screened earlier or more often.
Information from ACOG
Vaccines aren’t just for babies and young children. Adults also need to get vaccines.
What are vaccines?
Vaccines (sometimes called vaccinations or immunizations) are given to people to prevent disease. Vaccines are a mixture of cells and chemicals. Mostvaccines are given by injections (shots), but a few can be taken by nose, as a nasal spray.
If I am a healthy person, do I need vaccines?
Vaccines can help you stay healthy and avoid certain diseases. For example, a yearly flu shot can help keep you from catching the flu or greatly decrease the effect of the flu if you do catch it. Even though you are healthy, your work, travel, or life in general may expose you to serious illnesses like hepatitis. Vaccines can help you avoid illness, great expense, or even death.
Are there risks to vaccines?
Vaccines are very safe. Generally, being sick with the disease is much more dangerous than getting the vaccine. Most vaccines used in the United Statesare made from a killed or inactive virus, so the vaccines cannot give you the disease. People with some health conditions – like pregnancy – should notget certain vaccines. Most vaccines cause soreness at the injection site and a few can cause a flu-like feeling, which lasts for a day or so. Ask your healthcare professional which vaccines are safe for you and how you should expect to feel after getting them.
How do I know if I need any vaccines?
The table in this handout has information on which vaccines you may need as an adult. If you work or travel outside the United States, you may also needother vaccines. Your local health department or the Centers for Disease Control & Prevention (CDC) can provide information about what vaccines youwill need for travel.
a You are at risk for Hepatitis A if you: 1) live in a community that has a high incidence of Hepatitis A, 2) use street drugs, or 3) have chronic liver disease.
b You are at risk for Hepatitis B if you: 1) have had more than one sex partner in 6 months, 2) have sex or household contact with a person who has Hepatitis B, 3) use streetdrugs, or 4) are a health care or public safety worker who could have contact with body fluids.
cYou should get a flu vaccine with inactivated virus every year if you: 1) are over age 65, 2) are a health care worker, 3) are pregnant, or 4) have long-term health problems such a diabetes, asthma, kidney disease, or heart disease.
Can I get vaccines if I am pregnant?
The flu vaccine and the tetanus, diphtheria, and pertussis (Tdap) vaccine are recommended for all pregnant women. The hepatitis A and B vaccines are also recommended for women at risk for the infection. Some vaccines should not be given to pregnant women. These include the human papillomavirus (HPV), live flu, measles, mumps, and rubella (MMR), and varicella (chickenpox) vaccines. Right after pregnancy is a good time to get the hepatitis, MMR,and varicella vaccines if you need them.
From the Journal of Midwifery
What is human papillomavirus (HPV)?
Human papillomavirus (HPV) is a virus. Like all viruses, HPV causes infection by entering cells. Once inside a cell, HPV takes control of the cell’s internal machinery and uses it to make copies of itself. These copies then infect other nearby cells.
There are more than 150 types of HPV. About 40 types infect the genital area of men and women and are spread by skin-to-skin contact during vaginal, anal, or oral sex. Genital HPV infection can occur even if you do not have sexual intercourse.
HPV infection is the most common sexually transmitted infection (STI) in the United States. Almost everyone who is sexually active will get an HPV infection at some point during their life.
Like many other STIs, genital HPV infection often has no signs or symptoms. The infected person usually is not aware that he or she has been infected and can unknowingly pass the infection to others.
HPV can cause the following diseases:
No. In most people, the immune system fights most high-risk and low-risk HPV infections and clears them from the body.
Infections that are not cleared from the body are called persistent infections. A persistent infection with a high-risk HPV type can cause cells to become abnormal and can lead to a condition called precancer. It usually takes years for this to happen. Cervical cancer screening can detect signs of abnormal cell changes of the cervix and allows early treatment so they do not become cancer.
A vaccine is available that can prevent infection with HPV. The vaccine protects against the HPV types that are the most common cause of cancer, precancer, and genital warts.
Girls and boys should get the HPV vaccine as a series of shots. Vaccination works best when it is done before a person is sexually active and exposed to HPV, but it still can reduce the risk of getting HPV if given after a person has become sexually active. The ideal age for HPV vaccination is age 11 years or 12 years, but it can be given starting at age 9 years and through age 26 years.
For those aged 9–14 years, two shots of vaccine are recommended. The second shot should be given 6–12 months after the first one. For those aged 15 years through 26 years, three shots of vaccine are recommended.
If your child has not gotten all of the recommended shots, he or she does not need to “start over.” He or she can get the next shot that is due even if the time between them is longer than recommended. This is also true for you if you have not completed the recommended number of shots through age 26 years.
Studies show that getting all doses of the HPV vaccine before you are sexually active can reduce your risk of getting certain types of HPV-related cancer by up to 99%. If you have had sex, you may already be infected with one or more types of HPV, but you can still get the vaccine if you are younger than 26 years. The vaccine may help protect you against the other types of HPV included in the vaccine that you are not infected with.
Millions of people have been vaccinated against HPV since the vaccine came out. There have been no reports of severe side effects or bad reactions to the vaccine. The most common side effect of the HPV vaccine is soreness and redness where the shot is given.
Yes. HPV vaccination helps prevent HPV infection. It is not a cure for an HPV infection that has already occurred. Women who have been vaccinated still need to have regular cervical cancer screening as recommended for their age group and health history (see FAQ085 Cervical Cancer Screening).
Even if you get the HPV vaccine, it still is important to take other steps to protect yourself against HPV and other STIs:
Information from ACOG
Vulvar Skin Care
GUIDELINES FOR VULVAR SKIN CARE
- Use mild enzyme-free soap (such as Woolite Gentle Cycle or All Free and Clear) on any clothing that comes in contact with your vulva (use 1/3 to 1/2 the suggested amount per load). Other clothing may be washed in the soap of your choice.
- Do not use fabric softener or dryer sheets on any clothing that comes in contact with your vulva.
- Look for underwear or exercise clothes with “cool max” or breathable “wick-away” fabric. Wear all-cotton underpants—not nylon with cotton crotch.
- Thongs may cause irritation due to mechanical rubbing.
- Avoid pantyhose. Many manufacturers are making thigh-high stockings. Opt for these instead.
- Avoid tight clothing and clothing made of synthetic fabrics. Remove wet bathing suits and exercise clothing as soon as you can. These will not cause a yeast infection but can mechanically irritate the vulvar area.
Bathing and Hygiene:
- Avoid bathing soaps, body washes, lotions, gels, and other products which contain perfume. No soap is best in the vaginal region. If you must use soap, Aveeno Oatmeal and Neutrogena soaps are recommended.
- Do not scrub vulvar skin with a washcloth; washing with your hands or running water is sufficient.
- Avoid all bubble baths, bath salts, scented oils, and hot water.
- Pat dry rather than rubbing with a towel.
- Avoid all over-the-counter creams or ointments and anti-yeast medications with asking your health care provider first. Remember: anything used locally in the vaginal are has the potential to cause during irritation. Do not use Vagisil.
- Never douche
- Avoid the use of deodorized pads and tampons. Do not use Always pads or minipads. Tampons should only be used when the flow of blood is enough to soak one tampon in four hours or less. Tampons are safe for most women, but wearing them too long or when the flow of blood is light may result in vaginal infection, increased discharge, or toxic shock syndrome. If pads are irritating, consider using “natracare pads.” These pads can be found in health food stores.
- Do not shave the vulvar area. Shaving may cause irritation and lead to infection
- Avoid scented toilet paper.
- Avoid all feminine hygiene sprays, perfumes, adult, or baby wipes. Pour lukewarm water over the vulva after urinating if urination causes burning. Pat dry rather than rubbing with a towel.
- Soak in lukewarm bathwater with 4-5 tablespoons of baking soda or Aveeno Oatmeal soak to soothe vulvar itching and burning. Soak 2-3 times a day for 10-15 minutes. If you are busy, a cool compress with help, as will splashing down with cool water.
- To decrease irritation, small amounts of A&D Ointment or Crisco Shortening may be applied to the vulva as often as needed to protect skin. This may also help to decrease skin irritation during your period and after urination.
- Dryness during intercourse may be helped by using a lubricant. A small amount of almond oil, which can be obtained at health food stores, is recommended for lubrication. Astroglide, available from the pharmacy, should be used with condoms. If you use condoms, we suggest you use non-latex polyurethane condoms, such as Avanti or Trojan (certain ones) brands. Latex condoms cannot be used with almond oil.
- The new low-dose birth control pills do not seem to increase the chances of getting a yeast infection.
- Contraceptive jellies, creams, or sponges may cause itching and burning. A brand change may be helpful. Discuss the different brands available with your health care provider.
- Smoking has anti-estrogenic properties. Stop smoking! This will contribute to vaginal health.
TIPS FOR WEIGHT LOSS AND EXERCISE
As health care providers, we often hear, “How can I lose this weight? I eat very little and I exercise a lot and the weight just doesn’t come off.”
Here are some tips that may help to turn this situation to your benefit.
- First get a good physical examination. There may be a medical reason for the weight gain. Discuss with your provider any symptoms you may be having. Also review your activity level and diet with your provider. Before your appointment, make a list of the medications and herbs that you take routinely. Discuss these meds with your provider to make sure that they are not the cause of the weight gain. Your provider may order labwork to rule out medical conditions that could impair weight loss.
- Monitor your heart and breathing. A simple way to monitor your output is to use the Borg Scale of Perceived Exertion. You want to make sure that you are exercising at a high enough level to get results but not push yourself so hard you are gasping for breath. The scale has a 1- 10 rating, where 1 is napping and 10 is running as fast as you can. You should be at about 6-7 on the scale—short of breathe but still able to talk and you should be sweating too. Of course, before starting any exercise program, check with your provider first if you have any medical issues.
- Keep a food diary. It is easy to underestimate the calories that we consume in a day. A slice of cheese, a handful of pretzels , and a latte can pack on 300-500 calories in no time. For 1 week weigh, measure and write down EVERYTHING you eat. There are great apps for smartphones and the ipod/ipad that can help you with this chore. There are also some great calories counting sites on google.com. If, after one week, you cannot figure out where to cut calories, schedule a visit with a dietician, who can help you put together a realistic plan to help you lose weight. We can direct you to these professionals if you need assistance.
- Use a pedometer. Many cardiologists recommend the 10,000 step program. Keep a record for 1 week of how many steps you take in your normal day, using your pedometer of course! Then try to increase your daily steps to 10,000/day. If you are already walking that much, add another 2,000 steps to get the results you want. Remember, you add lots of extra steps a day by just doing things like parking your car to the far side of a parking lot and walking from there to a store, or climbing up 1 or 2 flights of stairs instead of taking an elevator. Every little bit helps!!
- Add strength training. Muscle is more metabolically active than fat. Adding strength to your muscles by using free weights, resistance bands, or the machines at your gym , will increase your lean tissue and boost your overall metabolism. You should try to do weight training 2 times per week. Yoga is another way to build body strength. It can also improve your flexibility, help prevent osteoporosis, and relieve stress . Stress relief, by the way, is another way to lose weight. High cortisol levels that occur when we are under a lot of stress really can cause us to “pack on the pounds”.
- Change your pace. The same exercise routine daily can lead to boredom . This may be causing you to not exercise at a “fat burning” capacity. Add a few short bursts of quick-paced intensity to your routine, whether that is while you are riding your bike, taking your daily walk with your dog, or sitting on your stationary bike in front of the TV. Listening to high-energy music on your ipod can really help you pick up the pace also.
- Enjoy what you are doing. Find an exercise routine that you like. Get a friend to exercise with you . Don’t worry about how many pounds are coming off. Just enjoy the fact that you are making yourself healthier and, hopefully, happier too.
- Get plenty of rest. Sleep deprivation can actually increase fat storage in your body. Also fatigue during the day can sabotage your exercise program and cause you to eat more.
Good luck and enjoy the path to a healthier you!
*Much of the information here was excerpted from the column by Linda Buch, a personal trainer and Lancaster native, in the Lancaster Sunday News of September 11, 2011.
Nutrition Information: Fiber, Folate, Iron, Protein
Why is fiber so important?
Fiber or roughage is the indigestible part of a plant that pushes through our digestive tract. There are two main types of dietary fiber: soluble and insoluble. Soluble fiber, such as bran, nuts, seeds and beans, holds water and turns to gel during digestion. Insoluble fiber, by contrast, speeds the passage of foods through the stomach.
You should aim for 25 grams of fiber per day.
Getting adequate fiber has many benefits:
- relieves constipation and other digestive trouble
- makes stool easier to pass, preventing constipation, hemorrhoids and diverticulitis (inflammation of the intestine), as well as helping some of the symptoms of irritable bowel syndrome (IBS), such as diarrhea, abdominal pain, and gas
- aids in weight management, since high-fiber foods take longer to chew, sending the signal to your body that you are full faster
- helps lower serum cholesterol levels, improving heart health
- better blood sugar control
If you need to increase your fiber intake, here are some great sources from real food:
- Fresh fruits (including skins when possible), such as apples, apricots, bananas, berries, grapes, grapefruit, oranges, peaches, pears, pineapple, and tangerines.
- Fresh vegetables, such as asparagus, bean sprouts, broccoli, brussel sprouts, cabbage, carrots, cauliflower, celery, corn, cucumber, green beans, leafy greens, okra, peppers, potatoes (with skin), squash, sweet potatoes, tomatoes.
- Dried fruits, such as apples, dates, figs, peaches, pears, and prunes.
- Dried beans, peas or lentils, such as black-eyed peas, black beans, garbanzo beans, kidney beans, lima beans, navy beans, pinto beans, split peas
- Whole grains, such as barley, bran, brown rice, buckwheat, bulgar, cornmeal, grits, graham, millet, oatmeal, oat bran, rye, whole wheat, wheat germ, wheat berries, cracked wheat, wild rice
- Whole grain crackers, such as AK mok, sesame crackers, graham crackers, Rye Krisp, Triscuits, Stoned Wheat crackers, Wheatsworth, whole wheat/bran matzos, oat bran crackers
- Other: bran muffins, granola bars, nuts, oatmeal cookies, popcorn, peanuts, seeds (sesame, sunflower, pumpkin), trail mix, whole wheat pasta
NOTE: increase fiber intake gradually, drink fluids liberally, avoid excessive amounts of fiber.
Folate, or Folic Acid, is a type of B Vitamin. It helps to:
- make DNA
- repair DNA
- produce red blood cells (RBCs)
If you don’t have enough folate in your diet, you may end up with a folate deficiency. Certain drinks and foods, such as citrus juices and dark green vegetables, are particularly good sources of folate. Not eating enough folate can lead to a deficiency in just a few weeks. Deficiency may also occur if you have a disease or genetic mutation that prevents your body from absorbing or converting folate to its usable form.
Folate deficiency can cause anemia. Anemia is a condition in which you have too few RBCs. Anemia can deprive your tissues of oxygen it needs because RBCs carry the oxygen. This may affect their function.
Folate is particularly important in women of childbearing age. A folate deficiency during pregnancy can lead to birth defects. Most people get enough folate from food. Many foods now have additional folate to prevent deficiency. Nevertheless, supplements are recommended for women who may become pregnant. For more information on this, check out Oh, Baby! Prenatal Vitamins
Here are some great ways to get folate from food:
- Fortified Breakfast Cereal
- Black-eyes peas
- Orange juice
- Greens (collard, turnip, kale, mustard)
- Pineapple juice
- Liver, organ meats
- Brussel sprout
Vegetables should be eaten raw or cooked briefly in a small amount of water.
Low iron is the most common nutritional deficiency in the U.S. Almost 10% of women are iron deficient, according to figures from the Centers for Disease Control and Prevention, but many people do not know what a vital nutrient it is.
Iron transports oxygen through your body. Iron is an important component of hemoglobin, the substance in red blood cells that carries oxygen from your lungs to transport it throughout your body. Hemoglobin represents about two-thirds of the body’s iron.
That’s one reason why, if you are low in iron, you may feel exhausted or fatigue easily with moderate exertion. You may also have decreased brain function and an impaired immune system.
Iron is also important for healthy cells, skin, hair, and nails.
Young women, ages 9 to 13 need about 8 grams of iron. Starting in adolescence, a woman’s iron needs increase due to losing blood each menstrual cycle. Women through about age 50 need 18 grams of iron daily.
Here are some great ways to get iron through food. If this is not adequate, talk to you provider about adding an iron supplement.
- Liver and other organ meats
- Clams, oysters, sardines
- Beef and pork
- Pork and beans
- Chili con carne
- Blackstrap molasses
- Raisins, dried apricots/figs/prunes
- Prune juice
- Dried peas, beans
- Fortified breakfast cereals (check your labels!)
Protein is used by the body for building and preparing cells, muscles, and tissues, and for energy. There is some debate over how much protein a person should have every day, so you may need to experiment to find what works best for your body. The Recommended Daily Allowance (RDA) is about 10% of your daily calories. This is a minimum. Many people suggest at least 20% of daily calories or 1.6-2 grams per kilogram of body weight should come from protein.
Protein is found mostly in foods which come from animals, but some plant foods also have protein.
Foods which are high in protein are:
Milk Products group:
- all types of cheese, including cottage cheese
Animal Sources group:
- poultry: chicken, turkey, duck, goose, pheasant, etc.
- pork and ham
Plant Sources group:
- beans and peas: canned or dry including lentils, navy beans, kidney beans, garbanzo beans, pinto beans, lima beans, soybeans
- nuts and nut butter, such as peanut, walnut, almonds, cashews, etc.
Cigarettes Facts and Smoking Cessation
Tobacco contains over 4,000 chemicals. Here are just a few:
|Ammonia: used in household cleaners and dry cleaning fluid||Polonium:radiation equal to 300 chest x-rays in one year|
|Cadmium:found in phosphate fertilizers and batteries||Nicotine: addictive drug that effects your mood and performance|
|Hydrazine:used in jet and rocket fuel||Toluene:used in polyurethane|
|Formaldehyde: embalming fluid, must have a license to obtain||Benzene: found in all gasoline grades; caution recommended when exposed to this chemical|
|Acetic Acid: found in hair dye and photo developer; gloves must be worn when handling both of these substances||Acetone:used as a solvent, found in paint, fingernail polish remover|
|Naphthalene: ingredient in explosives, moth balls, and paint pigments||Hydrogen Cyanide: found in all gas chambers|
|Arsenic: used in rat poison; most rats love the taste||Butane: used in cigarette lighters|
|Carbon Monoxide: a colorless, odorless, highly poisonous gas that comes out of car exhausts||Over 50 of these 4,000 chemicals can cause cancer in humans? Take control today.|
IDEAS TO HELP YOU QUIT
If you smoke for stimulation, try:
- getting enough rest
- exercising regularly (moving is a drug-free stimulant)
- eating regular, nutritious meals
- drinking lots of cold water
If you smoke for pleasure, remember:
- how good foods taste now
- you feel and look fresh in social situations without smoking
- how much easier it is to walk, run, and climb stairs without smoke in your lungs
- how good it feels to be in control of the urge to smoke
- that you can spend the money you save on something else you enjoy
- all the myriad health benefits of quitting
If your obstacle is handling the cigarettes, try to:
- picking up a pen or pencil
- playing with a coin, twisting a ring, or handling any harmless object
- eating regular meals
- finding a hobby that keeps your hands busy
- having a low-fat, low-sugar snack like carrot sticks, apple slices, or a bread stick
Tips for tension reduction:
- use relaxation techniques
- exercise regularly
- remember that smoking does not resolve problems; figure out what will, and act
- avoid or get out of stressful situations
- get enough rest
- enjoy relaxation: take a hot bath, have a massage, lay in the hammock, listen to music
To deal with cravings:
- explore using nicotine replacement therapy
- smoke more than you want for a day or two before you quit; this “overkill” may spoil your taste for cigarettes
- remember that smoking even one cigarette will make you want more
- tell family and friends that you’ve quit; ask for help, let them know what they can do
- think of yourself as a non-smoker; hang up “No Smoking” signs
- remember that physical withdrawal lasts about 2 weeks; you can make it, hang on!
If you are having problems dealing with the habit of smoking:
- change your smoking routines; keep your cigarettes in a different place, smoke with the opposite hand; limit smoking to certain places
- be aware of every cigarette you smoke; ask “do I REALLY want this cigarette?”
Information from the Clean Air for Healthy Children chapter of the American Academy of Pediatrics
Cigarette Withdrawal and Recovery
SMOKING WITHDRAWAL SYMPTOMS
One of the reasons that nicotine is believed to be an addictive drug is the a variety of physical symptoms and certain feels are experienced when the drug is stopped. These are called physical and psychological withdrawal or symptoms of recovery. They are signs that the body is healing and adjusting itself back to when it was nicotine-free.
Because each person’s smoking habit is unique, her recovery experience in quitting will be as well. The variation of feelings, symptoms, and degrees of discomfort will be unique to each smoker. Most symptoms are temporary and decrease sharply during the first few days of cessation, followed by a continued, but slower rate in decline in the following weeks. For some smokers, dealing with withdrawal symptoms may be like “riding a roller coaster” with sharp turns, and ups and downs. The good news is that most symptoms will pass within two to four weeks after quitting.
Remember: having even one cigarette after you have tried to qui will only cause symptoms of recovery to return and last longer.
|Craving||physical addition to nicotine, habits, and psychological dependence; the body misses nicotine and sends signals by giving you cravings to smoke||most frequent during first 2-3 days, may continue for months or years||wait out the urge
Nicotine Replacement Therapy (NRT)
|Emotional symptoms: irritability, impatience, anger, sadness||body’s physical and emotional craving for nicotine||2 to 4 weeks||express your emotions
ask others to be patient
walks, hot baths
|Fatigue||no loner have nicotine as an artificial stimulant in the body||2 to 4 weeks||take naps
increase physical activity
do not push yourself
|Sleep Disturbances: difficulty falling asleep, waking up too early, frequent awakenings||Nicotine affects brain wave functions, influences sleep patterns; dreams about smoking are common||a few days||increase awake activity
avoid caffeine after 6 pm
deep breathing to relax
regular sleep patterns
drink milk before bed
|Dizziness or Light-headedness||carbon monoxide is no longer robbing blood cells of oxygen, you are now functioning on a normal supply and need to adjust||1 to 2 days||take extra caution
change position slowly
this feeling will pass
|Lack of Concentration||body needs time to adjust to not having constant stimulation from nicotine||a few days||plan work accordingly
avoid additional stresses
BENEFITS TO QUITTING SMOKING
Hoe the body repairs itself:
After 20 minutes:
- Blood pressure drops to normal
- Pulse rate drops to normal
- Body temperature of hands and feet increase to normal
After 8 Hours:
- Oxygen level in blood increases to normal
After 24 Hours:
- Chance of heart attack decreases
- Less short of breath
After 36 Hours:
- Carbon monoxide levels return to non-smoking levels
After 48 Hours:
- Nerve endings start re-growing
- Ability to smell and taste is enhanced
After 2-3 Weeks:
- Circulation improves
- Walking becomes easier
- Lung function increases up to 30%
After 1-9 Months:
- Coughing, sinus congestion, fatigue, shortness of breath decreases
- Cilia re-grow in lungs, increasing ability to handle mucous, clean the lungs, and reduce infection
- Body’s overall energy increases
After 1 Year:
- Excess risk of coronary heart disease is half that of a smoker
After 5 Years:
- Lung cancer death rate for average former smoker decreases by almost half
- Stroke risk is reduced to that of a nonsmoker 5-15 years after quitting
- Risk of cancer in the mouth, throat, and esophagus is half that of a smoker’s
After 10 Years:
- Lung cancer death rate similar to that of non-smokers
- Pre-cancerous cells are replaced
- Risk of cancer of the mouth, throat, esophagus, bladder, kidney, and pancreas decreases
After 15 Years:
- Risk of coronary heart disease is that of a non-smoker