Archive for the ‘Women’s Health’ Category

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Low-level laser therapy helps breast cancer-related lymphedema

Monday, May 31st, 2010

Supportive Care in CancerLymphedema is swelling due to engorgement with lymph fluid. In the case of  breast cancer it occurs after therapies that remove lymph nodes and damage delicate lymph vessels cause a stagnation of the lymph fluid. Breast cancer-related lymphedema is uncomfortable and a risk factor for infection due to impaired lymphatic drainage in the affected arm. A paper just published in the journal Supportive Care in Cancer reports on the effectiveness of low-level laser therapy (LLLT, also known as ‘cold’ laser therapy to distinguish it from cutting surgical lasers) in the treatment of BCRL. The authors begin by observing:

“Breast-cancer-related lymphedema (BCRL) is a chronic disease, and currently there is no definitive treatment for it…Low-level laser therapy (LLLT) has been used in the treatment of post-mastectomy lymphedema since 2007 in the US. The aim of this study is to review our short-term experience with LLLT in the treatment of BCRL.”

The authors assessed the circumferences of both affected and unaffected arms (swelling), pain, restriction due to scars, and range of motion of the affected arm to gauge the impact of LLLT. The outcomes led to this conclusion:

“Patients with BCRL received additional benefits from LLLT when used in conjunction with standard lymphedema treatment. These benefits include reduction in limb circumference, pain, increase in range of motion and scar mobility. Additionally, two cycles of LLLT were found to be superior to one in this study.”

Note: Low-level laser therapy is widely available (including at Lapis Light), comfortable and non-invasive.

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Posted in Oncology, Women's Health | 6 Comments »

Broccoli sulforaphane inhibits breast cancer stem cells

Monday, May 24th, 2010

Clinical Cancer ResearchThe authors of this study just published in the journal Clinical Cancer Research begin their report by noting:

“The existence of cancer stem cells (CSCs) in breast cancer has profound implications for cancer prevention. In this study, we evaluated sulforaphane, a natural compound derived from broccoli/broccoli sprouts, for its efficacy to inhibit breast CSCs and its potential mechanism.”

Their data showed a marked decrease in breast cancer stem cells in vivo,

“…thereby abrogating tumor growth after the reimplantation of primary tumor cells into the secondary mice.”

Their conclusion:

“Sulforaphane inhibits breast CSCs and downregulates the Wnt/β-catenin self-renewal pathway. These findings support the use of sulforaphane for the chemoprevention of breast cancer stem cells and warrant further clinical evaluation.”

Of course this is not the same as a full-blown study on sulforaphane as a treatment for breast cancer; but why not add broccoli and broccoli sprouts (if not one of the more concentrated preparations) to the diet?

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Posted in Oncology, Women's Health | 2 Comments »

Eat a Mediterranean diet for better sex

Saturday, May 22nd, 2010

Journal of Sexual MedicineTwo papers recently published in the Journal of Sexual Medicine document the benefit of the low glycemic Mediterranean diet for sexual function in both women and men. The authors of Adherence to Mediterranean Diet and Sexual Function in Women with Type 2 Diabetes evaluated how well they stuck to the diet and correlated it with sexual function…

“The Female Sexual Function Index (FSFI) was used for assessing the key dimensions of female sexual function.”

What did the data show?

“Diabetic women with the highest scores (of adherence to the diet) had lower BMI, waist circumference, and waist-to-hip ratio, a lower prevalence of depression, obesity and metabolic syndrome, a higher level of physical activity, and better glucose and lipid profiles…The proportion of sexually active women showed a significant increase…of adherence to Mediterranean diet…women with the highest score of adherence had a lower prevalence of sexual dysfunction…These associations remained significant after adjustment for many potential confounders.”

The authors of Adherence to Mediterranean Diet and Erectile Dysfunction in Men with Type 2 Diabetes conducted a similar investigation for men. This time the International Index of Erectile Function-5 was used as a metric for sexual function. Here’s what the data showed:

“The proportion of sexually active men showed a significant increase…of adherence to Mediterranean diet. Moreover, men with the highest score of adherence were more likely to have a lower prevalence of global ED and severe ED as compared with low adherers.”

No surprise, right? Low glycemic vegetables and fruits, lots of olive oil, nuts, a little wine, etc: the Mediterranean Diet.

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Posted in Healthy Aging, Men's Health, Women's Health | No Comments »

Higher estrogen predicts mortality in older women

Thursday, May 20th, 2010

Journal of the American Geriatrics SocietyA study published not long ago in the Journal of the American Geriatrics Society is a reminder that even natural estrogen at higher levels than the proper physiological range is detrimental. The authors aimed…

“To investigate the relationship between total estradiol (E2) levels and 9-year mortality in older postmenopausal women not taking hormone replacement therapy (HRT).”

The study participants were a representative sample of 509 women aged 65 and older living the Chianti region of Italy. What did their data show?

“Higher E2 levels were associated with a greater likelihood of death…independent of age, waist:hip ratio, C-reactive protein, education, cognitive function, physical activity, caloric intake, smoking, and chronic disease…The excessive risk of death associated with higher total E2 was not attenuated after adjustment for total testosterone and after further adjustment for insulin resistance…Total E2 was highly predictive of death after more than 5 years and not predictive of death for less than 5 years.”

This study highlights the importance of the functional management of estrogen levels even when HRT is not being used. All the more reason for cautious objective validation with the appropriate lab test (free-fraction bioactive estrogen) if we bear in mind the investigators’ conclusion:

“Higher total E2 concentration predicts mortality in older women not taking HRT.”

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Posted in Healthy Aging, Hormones, Uncategorized, Women's Health | No Comments »

Early pregnancy folate associated with child hyperactivity

Monday, May 17th, 2010

Journal of Child Psychology and PsychiatryThe authors of this paper recently published in the Journal of Child Psychology and Psychiatry being by noting:

“Maternal nutrition during pregnancy has been linked with fetal brain development and psychopathology in the offspring. We examined for associations of maternal folate status and dietary intake during pregnancy with brain growth and childhood behavioural difficulties in the offspring.”

They correlated maternal red blood cell folate (RCF) at 14 weeks of pregnancy and total folate intake (TFI) from food and supplements with their childrens’ behavioral difficulties. What did the data show?

“Lower maternal RCF and TFI in early pregnancy were associated with higher childhood hyperactivity and peer problems scores in the offspring….analyses showed significant inverse indirect associations of RCF with hyperactivity/inattention and peer problems via fetal brain growth.”

Their conclusion:

“…our data provide preliminary support for the hypothesis that lower folate status in early pregnancy might impair fetal brain development and affect hyperactivity/inattention and peer problems in childhood.”

Here we have another compelling reason to ascertain good folate status in early pregnancy, or (even better) before becoming pregnant. Although conventional blood tests for serum folate are not dependable, a convenient and reliable way to do determine folate adequacy is by measuring the organic acid formiminoglutamate in the urine.

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Posted in Brain Health, Children's Health, Women's Health | 1 Comment »

Vitamin D report misleading to the public

Friday, May 14th, 2010

JAMAA study was just published in JAMA (The Journal of the American Medical Association) that reports an increased risk for falls and fractures in older women who took vitamin D. The majority of studies reporting benefits for vitamins go unmentioned in the lay press, but this one was sensationalized. Headlines reading “Vitamin D increases falls and fractures”, which is contrary to a huge body of scientific evidence, are likely to mislead the lay reader. Here’s what the authors intended to do:

“To determine whether a single annual dose of 500 000 IU of cholecalciferol (D3) administered orally to older women in autumn or winter would improve adherence and reduce the risk of falls and fracture.”

That’s right, the dosage was 500,000 IU of vitamin D3 administered in one dose (the RDA has been 400 IU)! The study subjects were followed for 3 to 5 years, and their data generated this conclusion:

“Among older community-dwelling women, annual oral administration of high-dose cholecalciferol resulted in an increased risk of falls and fractures.”

Is this unexpected? No; vitamin D is a hormone, and any hormone at supraphysiologic (higher than natural) levels suppresses the function of its receptors and can eventually produce the same symptoms as its deficiency. I appreciate that the authors were attempting to see if a simplified dosage schedule could be used to promote compliance, but it makes about as much physiological sense as trying to eat all your food for one year in a single day. Unfortunately, many people reading only the lay publications will see only “Vitamin D causes fractures” when the opposite is true if supplemented properly: a daily dose based on individual need as determined by the correct blood test.

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Posted in General Science & Health, Women's Health | 1 Comment »

Trans fats increase risk of endometriosis

Monday, May 10th, 2010

Human ReproductionThe authors of this study published recently in the journal Human Reproduction analyzed 12 years of data from the Nurses’ Health Study II to discriminate any link between dietary fat intake and the risk of endometriosis. Their analysis revealed that…

“Although total fat consumption was not associated with endometriosis risk, those women in the highest fifth of long-chain omega-3 fatty acid consumption were 22% less likely to be diagnosed with endometriosis…In addition, those in the highest quintile of trans-unsaturated fat intake were 48% more likely to be diagnosed with endometriosis.”

Considering the other well-known deleterious effects of trans fats, their conclusion is easy to digest:

“These data suggest that specific types of dietary fat are associated with the incidence of laparoscopically confirmed endometriosis, and that these relations may indicate modifiable risk. This evidence additionally provides another disease association that supports efforts to remove trans fat from hydrogenated oils from the food supply.”

By the way, endometriosis is not always so easy to diagnose. Another paper published in the same journal documents the accuracy of a non-invasive diagnosis of endometriosis using plasma (blood) biomarkers:

“Plasma levels of IL-6, IL-8 and CA-125 were increased in all women with endometriosis and in those with minimal–mild endometriosis, compared with controls. In women with moderate–severe endometriosis, plasma levels of IL-6, IL-8 and CA-125, but also of hsCRP, were significantly higher than in controls.”

Yet again we see the diagnostic importance of cytokines (IL-6 and IL-8 in this case). The authors affirm that this method has good sensitivity and specificity:

“Using stepwise logistic regression, moderate–severe endometriosis was diagnosed with a sensitivity of 100% (specificity 84%) and minimal–mild endometriosis was detected with a sensitivity of 87% (specificity 71%) during the secretory phase.”

Action points: (1) Minimize trans fats in your diet in any case. (2) If you suspect an inflammatory disorder ask your doctor about tests for cytokines.

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Posted in Good Eating, Women's Health | 3 Comments »

Iron supplementation can cause a zinc deficiency—implications for anger and depression

Friday, May 7th, 2010

British Journal of NutritionEven borderline anemia due to mild iron deficiency has profound effects. But as this study recently published in the British Journal of Nutrition reveals, care must be taken to avoid creating a functional zinc deficiency even when iron supplementation is necessary. The authors begin by observing…

“Interventions to combat mild Fe deficiency in women of childbearing age may affect Zn nutriture.”

Three groups of subjects with low iron were randomly assigned to one of three groups: dietary advice, a daily iron supplement and placebo. Their data showed that serum zinc increased in the dietary advice group (who ate more meat) and the placebo group. In the iron supplement group zinc decreased, leading to their conclusion:

“Zn status was not improved compared with placebo by an Fe-based dietary intervention. However, a daily moderate-dose Fe supplement with meals appeared to lower Zn status in these young adult women.”

European Journal of Clinical NutritionAmong its many functions, zinc is involved in neurotransmitter production and the regulation of mood. This important study recently published in the European Journal of Clinical Nutrition begins with the observation…

“The relation of zinc (Zn) nutriture to brain development and function has been elucidated. The purpose of this study is to examine whether Zn supplementation improves mood states in young women.”

The authors used a double-blind, randomized and placebo-controlled procedure to correlate psychological measures, somatic symptoms and serum zinc in two groups who took either a multivitamin or a multivitamin with zinc daily for 10 weeks. What did their data reveal?

“Women who took MV and Zn showed a significant reduction in anger–hostility score and depression–dejection score in the Profile of Moods State (POMS) and a significant increase in serum Zn concentration, whereas women who took only MV did not.”

The authors summarized their findings by concluding:

“Our results suggest that Zn supplementation may be effective in reducing anger and depression.”

It’s easy to see the strong biological momentum to feeling angry and/or depressed around menstruation? Iron is a necessary co-factor for both serotonin and dopamine. Supplementing iron can reduce zinc status, also an important mood-regulating co-factor. Even without adding the hormonal component it’s clear why so many women need help with this.

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Posted in General Science & Health, Women's Health | 8 Comments »

Hormonal contraception linked to female sexual dysfunction

Thursday, May 6th, 2010

Journal of Sexual MedicineThe physiology of female hormonal contraception and its associated problems is an important and extensive topic.  This study just published in The Journal of Sexual Medicine addresses one sensitive aspect: the deleterious effect of hormonal contraception on female sexual function. The aim of the authors was:

“To investigate the prevalence and types of FSD (female sexual dysfunction) and the relationship between hormonal contraception (HC) and FSD in female German medical students.”

They analyzed data obtained from 1,086 female German students from six medical schools for sexual dysfunction associated with orgasm, desire, satisfaction, lubrication, pain and arousal included in the Female Sexual Function Index (FSFI). What did the data show?

“The method of contraception and smoking were factors with significant effect on the total FSFI score whereby hormonal contraception was associated with lower total FSFI scores and lower desire and arousal scores than no contraception and non-hormonal contraception only.”

The subjects at lowest risk for female sexual dysfunction (those who had the highest FSFI score) were the ones using condoms or other non-hormonal contraception. The authors state in their conclusion:

“The contraception method has a significant effect on the sexual functioning score and women using contraception, especially hormonal contraception, had lower sexual functioning scores.”

This makes sense, since inhibition of ovarian testosterone production and an increase of sex hormone binding globulin that “locks up” the available testosterone are among the dysregulating effects of hormonal contraception (free fraction bioactive testosterone is necessary for normal female arousal and satisfaction).

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Posted in Women's Health | 6 Comments »

Normal weight obesity: heart disease from being fat without looking fat

Saturday, May 1st, 2010

European Heart JournalThis study published not long ago in the European Heart Journal is consonant with my findings for certain patients (using bioelectric impedance analysis for body composition determination) who were slim in appearance but turned out to be metabolically obese. They had a proportionately large amount of fat packed around the internal organs that wasn’t apparent externally. High levels of visceral fat are associated with the chronic inflammation that is a fundamental cause of cardiovascular and other diseases. The authors of this paper suspected this phenomenon:

“We hypothesized that subjects with a normal body mass index (BMI), but high body fat (BF) content [normal weight obesity (NWO)], have a higher prevalence of cardiometabolic dysregulation and are at higher risk for cardiovascular (CV) mortality.”

They thoroughly evaluated 6171 subjects with body composition measurement, blood tests and cardiovascular risk factors. Their data showed that…

“The highest tertile of BF (>23.1% in men and >33.3% in women) was labeled as NWO. When compared with the low BF group, the prevalence of metabolic syndrome in subjects with NWO was four-fold higher. Subjects with NWO also had higher prevalence of dyslipidaemia, hypertension (men), and CV disease (women). After adjustment, women with NWO showed a significant 2.2-fold increased risk for CV mortality in comparison to the low BF group.”

This means that excessive levels of body fat can be present in someone of normal weight and appearance (“metabolic obesity”), contributing to cardiovascular damage in both men and women. In women there is a stronger association with death from cardiovascular disease.

The author’s conclusion:

“Normal weight obesity, defined as the combination of normal BMI and high BF content, is associated with a high prevalence of cardiometabolic dysregulation, metabolic syndrome, and CV risk factors. In women, NWO is independently associated with increased risk for CV mortality.”

Important: There are consumer devices such as scales marketed as bioelectric body composition instruments but these do not give accurate or reliable results. Dependability requires a medical-grade device that utilizes electrodes on both the lower and upper extremities along with validated algorithms.

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Posted in Cardiovascular, Insulin & Diabetes, Women's Health | 1 Comment »

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