New weight advice for pregnancy

New weight advice for pregnancy

Many newspapers have reported on new official guidelines for how women can manage their weight before, during and after pregnancy. The advice comes from the National Institute for Health and Clinical Excellence (NICE).



The importance of the guidelines is borne out by figures suggesting that more pregnant women than ever are overweight or obese. The Guardian suggests that, “15-20% of women getting pregnant are overweight or obese”. The Daily Mail puts the number higher, saying that “almost half of expectant mothers are overweight or obese”. It goes on to spell out the dangers of being obese or overweight during pregnancy, which include “fatal health conditions such as blood clots, pre-eclampsia, miscarriages and stillbirths”.

The newspapers also dispel the myth that women should eat for two during pregnancy. Further advice reported in the press includes taking at least 30 minutes of moderate exercise per day during pregnancy, and that pregnant women should avoid dieting and only need to have an extra 200 calories a day in the last three months of their pregnancy.

These guidelines are published by NICE, and are evidence-based. They are designed so that doctors can give women up-to-date reliable advice to follow to maintain a healthy weight before, during and after their pregnancy.
Where did the advice come from?

The advice has just been published by the National Institute for Health and Clinical Excellence (NICE) as part of its public health programme. NICE produces guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector.
What are the health risks of being obese during pregnancy?

Women who are obese (with a BMI over 30) when they become pregnant face an increased risk of complications such as diabetes, miscarriage, pre-eclampsia, blood clots and death. Obese women are also more likely to have an induced or longer labour, post-delivery bleeding and slower wound healing after delivery. They also tend to be less mobile, which can result in a need for more pain-relieving drugs during labour. These can be difficult to administer in obese women, resulting in a greater need for general anaesthesia with its associated risks.

For women who have gained weight between pregnancies, even a relatively small gain of 1-2 BMI units can increase the risk of high blood pressure or diabetes during their next pregnancy and may also increase the chance of giving birth to a large baby.
What sort of diet does NICE recommend?

NICE offers the following dietary advice to help women to achieve and maintain a healthy weight:
Base meals on starchy foods (such as potatoes, bread, rice and pasta), choosing wholegrain where possible.
Eat foods rich in fibre.
Eat at least five portions of fruit and vegetables per day in place of foods higher in fat or calories.
Eat as little as possible of fried foods, and drinks and confectionery high in sugars and fats.
Eat breakfast.
Watch portion size of meals and how often they are eaten.
What should women aim to weigh before getting pregnant?

Women with a BMI of 30 or more can achieve significant health benefits if they lose between 5-10% of their weight. Further weight loss to achieve a BMI within the healthy range of 18.5 and 24.9 is encouraged.
What about weight during pregnancy?

The amount of weight a woman may gain in pregnancy varies a great deal, and only some of it is due to increased body fat. The unborn child, placenta, amniotic fluid and increases in maternal blood and fluid volume all contribute to weight gain during pregnancy.
Dieting during pregnancy is not recommended as it may harm the health of the child.
There is no need to ‘eat for two’ or drink full-fat milk (as opposed to lower-fat milk). Energy needs do not change in the first six months of pregnancy. Only in the last three months do a woman’s energy needs increase by around 200 calories per day.

Moderate-intensity physical activity will not harm the mother or baby. At least 30 minutes per day of moderate intensity activity is recommended. This can include activities such as swimming or brisk walking. If women have not exercised routinely up to that point, they should begin with no more than three 15-minute sessions a week, increasing gradually to daily 30-minute sessions.
There are no formal evidence-based guidelines from the UK Government or professional bodies on what constitutes appropriate weight gain during pregnancy.
How do I safely lose weight after giving birth?

Women are encouraged to breastfeed, but are advised against dieting while breastfeeding. Women who feed their babies with breastmilk only for the first six months may require an additional 330 calories a day, but this may differ between individuals, and some of these additional calories will be derived from fat stores built up during pregnancy.

If the pregnancy and delivery are uncomplicated, mothers may start a mild exercise programme consisting of walking, pelvic floor exercises and stretching immediately after giving birth, but women should not resume high-impact activity too soon. Women who have had complicated deliveries or caesareans should not resume pre-pregnancy levels of physical activity before consulting their medical caregiver.
Health professionals should be able to provide details of appropriate community-based services for women who want support to lose weight.
Where can I get more information?

Women should consult their GP or midwife about maintaining a healthy lifestyle before, after and during their pregnancy.

5 Superfoods You Can Sneak into Anything

5 Superfoods You Can Sneak into Anything



We’re not sure what exactly qualifies an ingredient to be a “superfood,” but we do know that we want these nutritious items in our diets. While almost all whole foods have lots of nutritious benefits, superfoods have more than most. It’s not always easy to get some of them into your diet, though. Luckily, there are a few superfoods that are easy to add into almost any dish. Make sure to pick these up next time you’re at the grocery store:

Chia Seeds

Chia seeds are a wonderful vegetarian source of protein and fat. They’re particularly known for their high omega-3 content, which is a super important fatty acid to have in your diet. Adding omega-3s into your diet can reduce inflammation in the body, according to the University of Maryland Medical Center, helping to protect you against chronic diseases such as arthritis, cancer and type 2 diabetes.

Don’t wait for recipes that call for chia seeds. Simply sprinkle them on everything: salads, bowls of oatmeal, sandwiches, smoothies, you name it! They’re a particularly wonderful addition to yogurt, as they provide some extra crunch.



Spinach

Spinach is a nutritional powerhouse. In addition to being a great plant-based source of protein, it’s high in fiber, calcium, iron, magnesium, potassium and folate.

There’s a reason why spinach is the most popular leafy green. It’s extremely versatile and has a mellow, crowd-pleasing taste. Add it to every salad and sandwich you make, blend it with your favorite fruit for a delicious smoothie (it will taste more like the fruit than the spinach, we promise!), or process it with nuts or avocado to create delicious pestos and other sauces.

Bone Broth

If you’re not vegan or vegetarian and you don’t currently cook with a homemade bone broth, you might want to start looking into it. Believe it or not, bone broth is incredibly nutritious. It contains glucosamine, which helps protect the bones and joints. It’s also rich in phosphorus, magnesium and calcium, a cocktail of nutrients that may support immune system health. Finally, it’s very rich in collagen, a protein that helps us stay looking and feeling young and healthy. Seniors especially may want to consider adding bone broth to their diets, as collagen production decreases with age.

To make bone broth, simply ask your local butcher for whatever bones he or she has lying around. Shape magazine says that you’ll probably get lots of discarded bone types, like feet, oxtail, necks and ankles. Put the bones in a large pot, add your favorite veggies for flavor (and even more nutrients) and cover with water. Simmer for one to three days, and you’ll have a super nutritious concoction that you can use for soups, drinks or sauteing. Freeze the broth in an ice tray and use a cube whenever you cook to boost the nutritional content of your meal.

Avocado

Oh avocado, how we love you. This delicious, rich fruit has been very en vogue for a few years now, and for good reason—it’s rich in healthy monounsaturated fat, as well as fiber and potassium.

Avocado tastes great on almost anything. Try it on sandwiches, in salads, in bowls of chili or other soups, or spread atop your protein source at dinner time. Add it to smoothies, or use it as a base for making vegan ice cream. Process it with olive oil, garlic and lemon for a delicious pasta sauce. If you love a food already, chances are you’ll love it even more with some avocado on top.

Blueberries

Blueberries are one of those fruits that it’s difficult to eat too much of. Blueberries are low in sugar, extremely rich in antioxidants and phytonutrients, and contain fiber, phosphorus, folate and vitamin C.

If you’re trying to boost your intake of blueberries, the best time to add them into your diet is at breakfast. They go great in cereals, smoothies and bowls of oatmeal or yogurt. Come lunch or dinner, they make a painless addition to salads. Or, eat them after dinner with some fresh organic cream for a nutritious dessert.

Top 12 Foods that Cause Inflammation

Top 12 Foods that Cause Inflammation

Everyday foods like bacon, eggs, coffee and dairy products are linked to inflammation. That might not sound like a big deal, but consider the fact that most chronic conditions like cancer, arthritis, diabetes, and obesity have been linked to inflammation. Low grade inflammation is a factor in most health issues. And if you suffer a pain disorder, you better believe that inflammatory foods will aggravate the condition.

Top 12 Foods that Cause Inflammation


Try reducing your consumption of these foods with the goal of eliminating them completely. The same holds true for alcohol and fried foods – both of these have been known to irritate and worsen arthritis.

Many common foods in the Standard North American Diet can cause or exacerbate inflammation in the body.

Below are my picks for the top 12 inflammatory foods:


1. What I call the “3 Ps”–Processed, packaged, or prepared foods. And, yes, fast food is atop the list of inflammatory foods thanks to the harmful oils, sugar and artificial sweeteners, food additives, and a whole host of nasty ingredients.

2. Hydrogenated and trans fats found in margarine, shortening, lard or products made with them. That includes baked goods, cookies, pies, buns. Of course there are healthier alternatives to these baked goods but most grocery stores and bakeries are using these harmful ingredients.

3. Meat (not wild-caught fish). I’m not suggesting that you need to go vegan or vegetarian here — although a plant-based diet tends to be much lower in inflammatory substances — but meat and poultry tend to cause inflammation; make them the background of your meals not the main dish.

4. Fried foods (French fries, onion rings, potato chips, nachos, hamburgers, etc.). I think these items speak for themselves.

5. White sugar and sweets, including soft drinks and sweetened juices. Newer research is showing that sugar is one of the most addictive substances you can use. It’s also highly inflammatory. No, you don’t need to eliminate sugar and sweets altogether simply reduce your consumption and choose fruit as your “go to” food when you’re craving something sweet.

6. Synthetic sweeteners (Nutrasweet, Splenda, saccharin, aspartame, AminoSweet, etc.)—research links these nasty substances to many serious health conditions. I avoid them like the plague.

7. Iodized Salt (use Celtic sea salt instead). Not harmful on its own but sodium is naturally found alongside other valuable minerals like potassium, calcium and magnesium. Choose unrefined salt which naturally contains many different minerals, not just sodium.

8. Food additives: colors, flavor enhancers, stabilizers, preservatives, etc. Some of the main ones include sulfites, benzoates, and colors named FD&C #”X.” Unfortunately, many foods consumed by children are loaded with these harmful, toxic ingredients.

9. Dairy products (yogurt, ice cream, cottage cheese, butter, cheese, etc.). Dairy products are packed with hormones, antibiotics, and other harmful ingredients so avoid them as much as possible.

10. Wheat products. Wheat is highly acid-forming and inflammatory in the body. Worse, most wheat available now is genetically-modified (GM). Many serious health conditions are starting to be linked to GM wheat consumption.

11. Other gluten-containing grains. Gluten is found in most grains and can be highly inflammatory. Choose grains or seeds like buckwheat, quinoa, or millet for your baking.

12. Alcohol. High in sugar and a burden to the liver, alcohol makes the top 12 inflammatory foods list. It is best eliminated or used in moderation.

Women More Likely Than Men to Binge Drink in College

Women More Likely Than Men to Binge Drink in College

FRIDAY, May 17 (HealthDay News) — It comes as little surprise that college students sometimes binge drink, but new research shows that college women are more likely to drink unhealthy amounts of alcohol on a weekly basis than are college men.

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Much of this difference is probably because the amount of alcohol that’s considered safe on a weekly basis is much lower for women than it is for men: seven drinks for women versus 14 for men. But, there’s good reason for that difference. Women don’t metabolize alcohol in the same way as men, and lesser amounts of alcohol can increase the risk of breast cancer and liver disease in women.

Throughout the study, 15 percent of women exceeded weekly drinking limits compared to 12 percent of men. In addition, men’s weekly drinking appeared to go down throughout the year, but not so for women.

“College women adopt a drinking style that will cause toxicity soon. Overall, women drink less than men do, but they don’t seem to know how much less they should be drinking in a week,” explained Bettina Hoeppner, lead study author and an assistant professor of psychology at Harvard Medical School.

Hoeppner said the biggest concern is that women may be setting themselves up for long-term health problems, particularly if they’re not aware of the safe weekly alcohol limits. She noted that women might think they’re fine if they don’t binge drink, but it’s easy to hit the weekly limit by just having a glass of wine with dinner every night.

The U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines low-risk drinking as no more than three drinks a day or seven drinks a week for women. For men, those limits are four drinks a day and 14 drinks a week.

The daily limits were set to avoid the physical and thinking problems that can occur from drinking too much in one day. The weekly limits took into account how much alcohol someone would need to consume to raise their risk of chronic health conditions, such as liver disease, sleep disorders, heart disease and some cancers.

Hoeppner’s study included 992 college students: 575 females and 417 males. The students provided biweekly reports of their daily drinking habits through a Web-based questionnaire.

Two-thirds of both the men and women exceeded the NIAAA weekly or daily guidelines at least once during the year, according to the study. Slightly more than 51 percent of the women and about 45 percent of the men exceeded weekly drinking limits at least once during the year.

Men were slightly more likely to exceed daily limits than women: 28 percent of men versus 25 percent of women, but the researchers said this difference wasn’t statistically significant.

The study findings appear online May 17 and in the upcoming October print issue of Alcoholism: Clinical & Experimental Research.

Dr. Marc Galanter, director of the division of alcoholism and drug abuse at the NYU Langone Medical Center, said he suspects that college women may be trying to drink as much as their male counterparts. “I think these young women are independent souls and are motivated to drink in a manner that’s similar to the way that men are drinking,” he said. “In terms of what’s considered normative, there isn’t much difference between men and women now.”

But, he cautioned, “Comparable levels of drinking for women have a greater impact in terms of intoxication.”

Study author Hoeppner said she didn’t think that women were necessarily trying to drink as much as men, just that they might not be as aware of what’s considered a safe weekly limit.

“Women need to be reminded that there are weekly limits, and women can exceed those limits quickly. It’s important to track the number of drinks you have per week, not just on occasion. And, alcohol prevention information should address the rationale behind weekly limits,” Hoeppner suggested.

5 Natural Health Tips for Type 2 Diabetes Prevention

5 Natural Health Tips for Type 2 Diabetes Prevention

Diabetes is the seventh leading cause of death in the U.S., according to the Centers for Disease Control and Prevention (CDC). It can lead to heart disease, stroke, kidney disease, blindness, or amputation, and it affects almost 26 million Americans. Another 79 million are at risk of developing type 2 diabetes.



Type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases of diabetes in adults. Type 2 diabetes in children and adolescents, although still rare, is being diagnosed more frequently. It usually begins as insulin resistance, a condition in which cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce it. Type 2 diabetes is associated with:

older age
obesity
family history of diabetes
history of gestational diabetes
impaired glucose metabolism
physical inactivity
race/ethnicity (African Americans, Hispanic/Latino Americans, American Indians, some Asian Americans and Native Hawaiians or other Pacific Islanders are at higher risk for type 2 diabetes and its complications)
Type 2 Diabetes Prevention
The National Diabetes Education Program (NDEP) says making small changes, like becoming more active and losing a small amount of weight if you’re overweight, can go a long way toward helping prevent or delay the onset of type 2 diabetes. Losing even 10 to 15 pounds – if you weigh 200 pounds – can make a big difference.

If you have diabetes, you can help prevent complications by making changes to reach your blood sugar, blood pressure, and cholesterol goals. The NDEP offers a “Make A Plan” tool to help identify, organize, and meet your goals, plus information on how to stop smoking and cope with stress.

During American Diabetes Month, the American Diabetes Association is calling for individuals to take a stand and support the move to Stop Diabetes® by participating in online information sharing and support.

Physicians from National University of Health Sciences offer some natural tips that may help reduce your risk for developing type 2 diabetes, and may be helpful if you already have it.

“Making a few relatively simple dietary and lifestyle changes, and adding additional screening to your annual physical, can go a long way in diabetes prevention,” says Dr. Brian Anderson, chiropractic physician at National’s on-campus integrative medical center. “Prevention steps are especially important if you have a family history of diabetes.”



5 Natural Health Tips for Type 2 Diabetes Prevention



1. Breakfast protein. Consume adequate protein for breakfast to help stabilize your blood sugar for the rest of the day. Dr. Anderson often recommends a meal replacement shake for breakfast with the following recipe: 2 scoops of your favorite protein powder, 6 – 8 ounces of yogurt or Kefir, 4 ounces of water, 1/2 cup of frozen berries.

2. Water. Start replacing sodas, commercial sports drinks, and other sugary drinks with water. “This is one of the biggest diabetes prevention tips for children and young people,” says Anderson. “Diabetes is striking increasingly younger age groups, and parents would do well to make water the first option when their kids are thirsty.”

3. Glycemic index. Educate yourself about the glycemic index and glycemic load and change dietary habits to choose foods lower on the glycemic index. Anderson explains that different foods can have a different impact on blood sugar elevation. Choosing foods that are lower on the glycemic index — for example, choosing whole grains over processed white flour products — can help stabilize your blood sugar levels.

4. Walk. Start using a pedometer and work your way up to 10,000 steps per day. Physical activity maintains insulin sensitivity. Even if you’re not up to a major workout, most people can walk more than they do.

5. Bio-impedance test. Have a bio-impedance test to give you your baseline body composition. A bio-impedance test can be performed by chiropractic physicians and will give you the most accurate measure of your body composition. A major risk factor in type 2 diabetes is obesity, so lowering body fat and gaining lean muscle mass is recommended.

National University of Health Sciences is a leading university for advanced degrees in complementary and alternative health.

Next: Diabetes takes many forms

Photo: Kim Steele/Photodisc/Thinkstock

All diabetes is not the same. In addition to type 2 diabetes, the National Diabetes Information Clearinghouse lists these other forms of diabetes:

Type 1 Diabetes
Type 1 diabetes is an autoimmune disease in which the immune system attacks and destroys insulin-producing beta cells in the pancreas. The exact cause of this is unknown. In time, the pancreas loses its ability to produce insulin. People with type 1 diabetes must take insulin every day to stay alive. Untreated, a person with type 1 diabetes can lapse into a life-threatening coma. There is no known prevention.

Type 1 diabetes represents about 5-10 percent of diabetes cases in the U.S. Anyone can develop type 1 diabetes, but it most often occurs in children or young adults. Symptoms include:

excessive thirst
increased urination
constant hunger
weight loss
blurred vision
fatigue
If your child has symptoms of diabetes, seek immediate medical help.

Gestational Diabetes
Diabetes can develop during pregnancy. About 3-8 percent of pregnant women in the U.S. develop gestational diabetes, but it usually resolves after childbirth. However, women who have gestational diabetes have a 40-60 percent chance of developing type 2 diabetes within 5 to 10 years.

Other Forms of Diabetes
Diabetes can also be caused by:

genetic defects in insulin action
diseases of the pancreas or conditions that damage the pancreas, such as pancreatitis and cystic fibrosis
excess amounts of certain hormones resulting from some medical conditions
medications or chemicals that reduce insulin action
infections, such as congenital rubella and mumps
rare immune-mediated disorders, such as stiff-man syndrome, an autoimmune disease of the central nervous system
genetic syndromes such as Down syndrome, Huntington’s chorea, and Prader-Willi syndrome
adults with latent autoimmune diabetes have signs of both type 1 and type 2 diabetes
The National Diabetes Information Clearinghouse (NDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH). For more information about diabetes, visit diabetes.niddk.nih.gov

5 tips for celebrating Men’s Health Week

5 tips for celebrating Men’s Health Week

The run-up to Father’s Day should be about more than ties, golf balls, and deciding what to grill on Sunday. Health should also be on the agenda.



Men’s Health Week was created by the U.S. Congress in 1994 to boost awareness of men’s health and ways to improve it. It’s a good time for men to contemplate their vigor, fitness, and overall health—and then do something about it.

Think you’re too old for that? It’s never too late to improve your health, no matter how old you are or what your current health status is. Here are five things you can you do to improve your health.

Get moving. Can you walk at a brisk pace for 2 miles? If so, you have a level of fitness sufficient to lower your chances of having a heart attack or dying from heart disease. If not, you can get there by putting one foot in front of the other, and going a bit further each day. Every increase in endurance translates to better health, including decreased risk of diabetes and possible protection from certain cancers. Plus you will feel better.

Get checked for colorectal cancer. If you are age 50 or older and have not been screened for colorectal cancer, you should. Of the various cancer screenings available to men, this one is the best deal because it can prevent, not just diagnose, cancer. A colonoscopy or similar procedure can find and remove precancerous colon polyps. If you have a sibling or parent who had a polyp removed before age 60, or had colon cancer at any age, it’s a good idea to start these checks sooner.

Know your blood pressure. If you don’t know your blood pressure, get it checked—and do whatever you have to do to keep it in a healthy range. High blood pressure, the proverbial “silent killer,” stalks systems throughout the body. Widespread damage occurs in the arteries, heart, kidneys, eyes, and brain. The ideal blood pressure is less than 120 over 80. Exercising more will have an immediate beneficial effect, as will cutting back on alcohol if you have more than one or two drinks a day.

Cut back on sodium in your diet. The average American man can easily take in 6 grams of sodium a day. That’s more than twice the recommended level. Most of this comes from eating fast foods, processed meats, canned and other prepared foods, and restaurant food. It’s just as important to add high potassium foods—including raisins, bananas, tomatoes, and spinach. Men who consume as much potassium as sodium have lower risks of heart disease. Start by reducing processed and pre-packaged food. Plan to cook some fresh meals during the week that include a vegetable, and save the leftovers for the next day.

Don’t ignore the warning signs. If you experience an unusual pain, ache, or other possible warning sign or symptom, don’t brush it off—as men are prone to do—as “probably nothing.” Blood in the urine or stool may be harmless, but it isn’t “normal.” It needs to be evaluated by a medical professional. Heart disease remains the leading killer of men and all Americans. Don’t ignore the signs:

Excessive sweating, shortness of breath, or exhaustion with exertion could be a treatable heart or lung problem.
Many men believe that the pain of a heart attack is felt only on the left side of the chest and moves to the left arm. It isn’t always that cut-and-dried. Heart-attack pain is often felt under the breastbone (sternum) and pain occurs in both arms as often as in the left arm alone.
Chest pain that is triggered by activity but that goes away with rest suggests angina (a narrowing of one or more coronary arteries) while oppressive pain that isn’t relieved by rest suggests a heart attack.
This week, give yourself the gift of good health. And keep it going beyond Father’s Day.

Will Eating Meat Give You Endometriosis?

Will Eating Meat Give You Endometriosis?


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If you eat dairy or meat, you’ll want to read this: Two pesticides carried in animal fat—beta-hexachlorocyclohexane (beta-h) and mirex—have just been shown to elevate women’s risk of endometriosis by up to 70%, according to new research by the Fred Hutchinson Cancer Research Center.

After testing the blood of 786 women in Washington state, researchers found that women with the highest levels of mirex were 50% more likely to have the condition, while women with even a moderate level of beta-h exposure were 70% more likely to have endometriosis, compared to women with the lowest levels. What's the connection? The pesticides’ estrogen-like qualities are thought to be responsible for the dramatic link between exposure and endometriosis, a painful, estrogen-driven condition where the lining of the uterus starts growing in other parts of the body.

But here’s the thing: Both pesticides, once popular insecticide and flame retardant additives, have been banned in the United States since the late 70s. So what in the world are they still doing in our veins?

“This class of pesticides is highly persistent; they’re not broken down in our bodies—they’re stored in our fat,” says study author Kristen Upson, PhD, of the National Institute of Environmental Health Sciences. The same is true for the fat of the animals we eat. “Our exposure is coming from the consumption of fatty foods like meat, dairy, and fish.”

Worse, these pesticides were sprayed over large swaths of land, undetectable but present in our environment. Although Dr. Upson declined to say whether cutting back on meat and dairy was a good way for women to reduce their exposure to the hormone-disrupting chemicals, it’s not hard to connect the dots.

“What I do know is there are now global efforts to create an international agreement to reduce and eliminate their use,” Dr. Upton says. “This finding really adds to our understanding of endometriosis and how environmental chemicals used in the past affect the current generation.” Learn more about the condition's symptoms and what to you if you suspect you have it with our complete guide to endometriosis.

8 Dermatologist Tips for Healthier Hair

8 Dermatologist Tips for Healthier Hair

Bad news for modern women: Many of today’s common hair care practices are not great for hair follicles. “The types of alopecia we’re seeing are different than what we were seeing 20 years ago because of the different types of processing that people are doing now,” says Roopal V. Kundu, MD, Associate Professor of Dermatology at Northwestern University’s Feinberg School of Medicine, “Whereas in the ‘70s and the early ‘80s the hairstyles were more natural, these days there’s a lot more crunched out styles in terms of perms and putting heat in the hair and keeping it straight, and a lot of tension.”

We spoke with Dr. Kundu about styling practices that lead to damage and simple ways to improve hair health. Ready for healthier hair? Check out Dr. Kundu’s tips:

1. Eat enough protein.

“The basic early advice is make sure you’re looking at your diet, make sure you’re getting enough iron, make sure you’re not anemic, make sure you have enough protein in your diet. Iron and protein are really important for hair health. We always try to make sure people get adequate protein for whatever they’re lifestyle is: If they’re sedentary, they don’t need as much. If they’re active, they need more.”
- Dr. Kundu

2. Get your vitamin levels checked and take supplements if need be.

“Iron levels are important for hair health. Women often develop iron-deficiency anemia because they aren’t getting enough iron. Iron-deficiency anemia can also develop due to normal monthly menstrual blood loss. There are some generic vitamins that we recommend: Vitamin D, omega, fish oils, a generic multivitamin with iron. Biotin is great in terms of hair strength and preventing breakage.”
- Dr. Kundu

3. Invest in silicone.

“There’s no magic product or ingredient, but if you want to add a little more protection you can use silicone -based products. Silicone basically coats the hair, which adds a little more protection once you do any kind of stress to the hair. Check a product’s list of ingredients and make sure silicone is high up on the list. Look for silicone or dimethicone, a silicone derivatives. Anti-frizz products usually have a silicone type of derivative. You can also try a leave-in conditioner, which also coats the hair.”
- Dr. Kundu

4. Be careful when styling at home.

“The problem with people treating hair at home is no one else is looking. Often people will come in who have damage to their scalp that they didn’t notice was there. Specific practices that can be problematic include straightening, processing, hair coloring, and heat. If you do those things at home, try to modify your hair care habits. So, try not to put heat on more than once a week, reduce the frequency of flat iron use, blow dry at a lower setting. It’s about frequency and amount.”
- Dr. Kundu

5. Never flat iron wet hair.

“Wet hair is more vulnerable to breakage. Either air dry or blow dry out soft, with a low setting, and then put the flat iron on. You shouldn’t put a flat iron on wet hair.”
- Dr. Kundu

6. Do not leave products in for longer than advised.

“Some people think products will be more effective if they leave them in longer than they should. They’ll be like, ‘Oh it’s tingling. That’s great. It must be working really well.’ That’s when damage can happen.”
- Dr. Kundu


7. If you feel pain while you’re at the salon, it’s time to find a new stylist.

“Hair styling shouldn’t hurt. Any kind of scalp discomfort is abnormal. That’s a very basic thing. A lot of people will come in and say, “It burned after a couple minutes of leaving it on, and then they came and washed it off.” Any form of sensation can be a sign that the scalp is being damaged. If you suffer any kind of discomfort while you’re at the salon, stop seeing that stylist. If you experience any burning, stinging, tingling, any kind of pain on their scalp after the styling is done, or during the process of it, you shouldn’t go back.”
- Dr. Kundu

8. Opt for looser hairstyles.

“Hair styling can cause problems in terms of alopecia. When braids or weaves are too tight, they hurt. Pain means it’s too tight, it’s pulling too hard. There’s too much tension. Try to keep ponytails and braids loose, not as tight, to reduce the amount of tension on the scalp.”

How to Care for Your Sensitive Skin

How to Care for Your Sensitive Skin

"Three-quarters of my patients call their skin sensitive," says Joshua Zeichner, MD, assistant professor of dermatology at The Mount Sinai Hospital in New York City, "and treating skin too aggressively is one main reason why." Even if you're not intending to, you could be overwhelming your skin: The average woman uses 12 different products with 168 unique ingredients every day, according to research from the Environmental Working Group in Washington D.C. All that on top of the usual stressors—pollution, hormonal changes, anxiety—and it's no wonder derms are seeing an increase in sensitive skin complaints such as breakouts, redness, rashes, and extreme dryness. Need relief? Check out these strategies for calming your complexion.

Having a Heart Attack? Women Less Likely to Feel Chest Pain

Having a Heart Attack? Women Less Likely to Feel Chest Pain

Acute coronary syndrome, which includes unstable angina and heart attack, is an umbrella term for conditions where blood supply to the heart muscle is suddenly blocked, according to the American Heart Association.

Chest pain is a classic symptom of acute coronary syndrome, but as many as 35 percent of patients do not report chest pain. These patients are more likely to be misdiagnosed in the emergency department and have a higher risk of death compared to patients who report chest pain, the study authors explained.

The researchers looked at about 1,000 patients, aged 55 and younger, who were hospitalized for acute coronary syndrome. The midpoint age of the patients was 49, and 30 percent were women.

Chest pain was reported by 80 percent of patients, but women were more likely than men to not have chest pain, 19 percent versus 13.7 percent.

For both sexes, the most common symptoms besides chest pain were weakness, feeling hot, shortness of breath, cold sweat and pain in the left arm or shoulder. Among patients without chest pain, women had more of these other symptoms than men, according to the study published online Sept. 16 in the journal JAMA Internal Medicine.

“The most significant findings in this study were that chest pain was the most predominant symptom of [acute coronary syndrome] in both men and women 55 years or younger,” regardless of syndrome type, wrote Dr. Nadia Khan, of the University of British Columbia in Vancouver, Canada, and colleagues.

But, they added, “women had a higher likelihood of presenting without chest pain than men. Most women and men who presented without chest pain, however, reported at least one other non-chest pain symptom, such as shortness of breath or weakness.”

The reasons for the sex differences in acute coronary syndrome symptoms was not clear, the study authors noted in a journal news release.

“Our findings indicate that chest pain is the predominant symptom that should direct diagnostic evaluation for [acute coronary syndrome],” the researchers noted. “However, health care providers should still maintain a high degree of suspicion for [acute coronary syndrome] in young patients, particularly women, given that one in five women with diagnosed [acute coronary syndrome] do not report with chest pain.”

More information

The American Heart Association has more about acute coronary syndrome.

New Omega-3 Study Shows No Brain Benefits for Senior Women


New research suggests that the omega-3 fatty acids found in fish and nuts may not have brain-saving powers for seniors.

Omega-3 fatty acids are said to have numerous health benefits, but new research casts doubt on one of them.

According to a study released Wednesday in the journal Neurology, omega-3 fatty acids may not have the brain-boosting benefits prior research suggested, at least not in healthy postmenopausal women.

Fish Oil Does Not Protect Against Mental Decline
Eric Ammann, a Ph.D. student in epidemiology at the University of Iowa College of Public Health, studied 2,157 women ages 65 to 80 who were part of the Women’s Health Initiative clinical trials of hormone therapy. As part of the study, the women had blood tests done to measure their levels of omega-3 fatty acids, as well as annual tests of their thinking and memory skills.

After an average of six years, the women with high levels of omega-3 fatty acids in their blood showed no difference in mental decline, compared with the women with low omega-3 levels.

Prior research showed that omega-3s have a protective effect on thinking skills, but Ammann’s research shows otherwise. He told Healthline that despite his findings, the matter is anything but settled.

"Our study was observational and should not be viewed as a definitive answer on the relationship between omega-3s and cognitive function. In making health-related decisions about diet and supplements, we would advise people to consider the total body of evidence and to consult with their healthcare providers," he said.

And the new findings don’t necessarily mean omega-3 fatty acids are useless in other respects, namely strengthening the heart, blood vessels, and brain.

"Based on proposed biological mechanisms, it is reasonable to hypothesize that omega-3s could be good for the brain," Ammann added. "Omega-3 fatty acids are a major constituent of neurons, and omega-3s may reduce the arterial hardening and inflammation that contribute to strokes."

Warding off mental decline in our golden years is a serious concern for medical professionals. Earlier this month, a study in the Canadian Medical Association Journal showed that even the best dementia drugs are ineffective at slowing the progression of mild cognitive impairment in seniors.

Dementia Drugs Ineffective at Slowing Mental Decline

"As with omega-3s, research on other interventions to delay cognitive decline isn’t settled science. Generally speaking, cardiovascular risk factors are somewhat predictive of dementia and cognitive decline," Aamann said. "Regular exercise, healthy eating, maintaining a healthy body weight, and blood pressure and cholesterol control could help. It is also possible that regular use of one’s cognitive skills and having a supportive social network could delay cognitive decline."

Fish Oil May Help With Diabetes
There is, however, plenty of other research that shows the health benefits of omega-3s, which are often taken in the form of fish oil supplements.

Earlier this year, researchers at the Harvard School of Public Health found that fish oil supplements rich in omega 3 fatty acids lower a person’s risk of type 2 diabetes and coronary heart disease. The research, published in The Journal of Clinical Endocrinology & Metabolism, found that the supplement helps increase levels of the hormone adiponectin, which helps the body regulate glucose levels and inflammation.

Fish Oil Supplements May Not Be Right for Everyone
Despite its potential benefits, fish oil may not be for everyone, especially men at a high risk for prostate cancer.

Research from the National Cancer Institute shows that men with high concentrations of omega-3 fatty acids in their blood have a 43 percent greater risk of developing prostate cancer, the most common cancer affecting men.

Researchers discovered this after studying 834 men with prostate cancer. Of them, 156 had high-grade cancer.

They found that men with higher concentrations of omega-3 fatty acids were more likely to develop cancer, while men with high concentrations of linoleic acid—an omega-6 fatty acid—had lower incidences of prostate cancer. Linoleic acid is found in high concentrations in salicornia, safflower, sunflower, poppy seed, grape seed, and evening primrose oils.

What Are Omega-3 Fatty Acids and Where Can I Find Them?
Omega-3 fatty acids are a type of “good” fat that’s been shown to lower LDL, or “bad,” cholesterol levels, reduce inflammation throughout the body, improve skin appearance, and help a person’s heart.

Omega-3s are common in many types of freshwater fish, flaxseed oil, nuts, and certain spices. Fish oil supplements high in omega-3 fatty acids have become one of the most common supplement types on the market.

According to a new review, heart disease in women is both more deadly and less likely to be properly treated than it is in men.

According to a new review, heart disease in women is both more deadly and less likely to be properly treated than it is in men.

Even though coronary artery disease (CAD) affects as many women as men, high-risk women are less likely to receive preventative treatments like statin medications or lifestyle advice, less likely to receive rehabilitation after a heart attack, and more likely to die from one. That's the conclusion of a new review paper published in Global Heart examining more than a hundred studies on CAD.

According to the American Heart Association, CAD is the leading cause of death in the United States for both men and women. But more women than men die of CAD, and more women have died of CAD than of cancer, respiratory disease, Alzheimer’s disease, and accidents combined.

“For far too long, many believed that coronary artery disease was primarily a ‘man’s disease,’” say the authors, Dr. Kavita Sharma and Dr. Martha Gulati of Ohio State University. “With increased awareness of the fact that the leading cause of death in women is CAD, this notion is slowly eroding.”

Perhaps not fast enough. A 2004 study found that fewer than one in five doctors knew that more women die from CAD than men each year. “CAD’s impact on women traditionally has been underappreciated due to higher rates at younger ages in men,” explain the study authors.

And this affects how doctors treat their patients. Studies have found that women who go to the hospital with chest pain or other urgent heart symptoms are less likely to receive blood thinners and less likely to undergo cardiac catheterization. Women with heart symptoms were also less likely to be given early aspirin, beta-blockers, or timely treatment to restore blood flow through blocked arteries.

Later Onset, Worse Outcomes for Women
Women with CAD tend to develop the disease about 10 years later in life than men do, but the consequences are worse. Women under 50 who have a heart attack are twice as likely to die, and women over 65 are more likely than men to die in the first year after having a heart attack.

Can differences in treatment explain this difference in outcomes? The picture isn’t so clear, Sharma and Gulati found, because coronary artery disease appears to develop differently in women than it does in men.

The classical pattern of CAD in men usually involves cholesterol buildup on the walls of the main arteries that send blood to the heart, partially blocking blood flow. But more than half of women with non-obstructive CAD have chest pain and undergo repeat hospitalizations.

When the researchers took a closer look, they discovered that women are much more likely to have diseased microvasculature, the web of tiny blood vessels that disperses blood from large arteries to nearby tissues. In men, heart attacks happened because an artery was blocked outright. In women, the heart muscle itself was slowly starved for oxygen until it failed.

Spot the Differences Between Men and Women
These differences in the development of heart disease suggest that both risk factors and treatment for CAD may differ between men and women.

As with men, CAD in women is affected by genetic and lifestyle factors: age, family history of heart disease, diabetes, obesity, high cholesterol, high blood pressure, smoking, and lack of exercise.

But how these factors predict CAD differs by gender. After age 60, CAD cases in men increase at a regular rate, while in women the rate increases exponentially. Moreover, diabetes increases a woman’s risk of developing CAD three- to seven-fold, but only increases a man’s risk two- to three-fold.

Women can also develop CAD as the result of conditions that do not or rarely affect men. For example, autoimmune diseases are far more common in women. One type of autoimmune disease, systemic lupus erythematosus, causes a 50-fold increase in the prevalence of CAD.

Women also undergo hormonal changes that men don't. Polycystic ovarian syndrome (PCOS) and the early age of a woman's first period both increased the risk of CAD later in life. This effect remained even after researchers controlled for a woman's weight. Women with breast cancer also experienced higher rates of CAD, though whether this is from the cancer or from hormonal treatments for it is unclear. Pregnant women also have additional risks, since preeclampsia and gestational diabetes both increase the likelihood of future CAD.

Now that the development of CAD in women is better understood, doctors can tailor treatments to female patients that specifically address microvasculature disease. Statins, beta-blockers, l-arginine, and a new drug called ranolazine can reduce CAD risk and symptoms.

However, much work remains to be done to raise the visibility of heart disease in women, expand treatment, and prevent unnecessary deaths.

"Want to quit smoking?

"Want to quit smoking? Forget trying to cut down, if you really want to kick the habit 'going cold turkey is the best option'," is the headline from the Mail Online.
The news website reports on a trial by UK-based researchers that aimed to assess whether it's better to stop smoking gradually or abruptly.

The researchers included almost 700 people and randomly assigned them to a gradual or abrupt stop in cigarette use. After four weeks, 39.2% of participants that gradually stopped smoking were still abstinent, compared with 49.0% that stopped smoking abruptly.
Both groups had access to nicotine replacement therapy (NRT), such as patches or gum, after the quit day. At six months, the proportion of participants that still abstained from smoking had reduced to 15.5% in the gradual group and 22.0% in the abrupt group.

The findings of this trial show promise, but going "cold turkey", as the headline suggests, may not be for everyone.

That said, setting a designated "quit day" can be useful, as you can put into place "strategies" that can help you improve your chances of quitting.
These include getting adequate stocks of NRT, or even something as simple as finding something to do with your hands – some people find worry beads very useful.
You can find your nearest NHS Stop Smoking Service on the NHS Smokefree website, or you can call the Smokefree National Helpline to speak to a trained adviser on 0300 123 1044.
What type of NRT is best?

By far the most popular NRT is e-cigarettes. But critics of e-cigarettes say they contain no "exit strategy": you're simply replacing one long-term nicotine delivery system with another.
Other types of NRT, such as gum, patches and throat sprays, are designed to wean you off your nicotine addiction over several months. Depending on your initial level of addiction, this can take 8 to 12 weeks.
on, Zyban (bupropion) and Champix (varenicline), that can help relieve cravings.
Read more about stop smoking treatments
Where did the story come from?

The study was carried out by researchers from the University of Oxford, the University of Birmingham, and University College London. Funding was provided by the British Heart Foundation.
It was published in the peer-reviewed journal, Annals of Internal Medicine.
The research has been presented accurately in the media. However, there has been no mention of the reduction in people remaining abstinent at six months, or whether this is a good method for long-term smoking cessation.

The press coverage does explain that for those who find it hard to stop abruptly, it is still better to attempt to cut down on smoking than do nothing at all.
Many of the reports include the phrase "going cold turkey". This is unhelpful, as it implies that people who stop abruptly have no treatment to help them cope with nicotine withdrawal symptoms.
The truth is that NRT can significantly reduce cigarette cravings. Evidence suggests people who quit using NRT are more likely to succeed than people who try to quit using willpower alone.
What kind of research was this?

This was a randomised controlled trial that aimed to assess the success of stopping smoking by a gradual method, compared with an abrupt stop.
This study design is best for examining such methods, as in theory the groups should be balanced for potential confounders and the differences in outcomes are the result of the intervention.  
What did the research involve?

The researchers included adult smokers who were addicted to tobacco but willing to quit.
Addiction was defined as any of the following:
smoking at least 15 cigarettes a day
smoking at least 12.5g of loose-leaf tobacco (a standard small pack of rolling tobacco)
end expiratory carbon monoxide concentration of at least 15 parts per million (ppm) – this is a measure of how much carbon monoxide a person exhales when breathing
Potential participants were excluded if they were:
currently receiving smoking cessation treatment
not able to take NRT

participating in other medical trials
not able to meet the demands of the trial
Participants were randomly assigned to stop smoking abruptly or reduce smoking gradually by 75% in the two weeks before quitting.

Participants from both groups were asked to set a "quit day" two weeks after joining the trial. The gradual group were to reduce their smoking by 50% in the first week and to 25% by the end of the second week. Participants in the abrupt group were asked to smoke as normal and not reduce between joining the trial and quit day.

The gradual-cessation group received short-acting NRT devices (such as gum or spray) as well as longer-acting nicotine patches before the quit day. The abrupt-cessation group only received nicotine patches before the quit day. Both groups had access to behavioural counselling, nicotine patches, and short-acting NRT after the quit day.

Participant characteristics were collected at the start of the study. These included:
smoking history
nicotine dependence
preference for gradual or abrupt cessation
At follow-up sessions in the clinic, assessments were made of the amount smoked and measured cotinine in the saliva – used as a marker for exposure to tobacco smoke – and exhaled carbon monoxide concentrations. Tobacco withdrawal symptoms were also measured using a standardised mood and physical symptoms scale.

The researchers measured abstinence from smoking four weeks and six months after the quit day. The analysis used assumes that any participants lost to follow-up were smokers.
What were the basic results?

From June 2009 to December 2011, there were a total of 697 participants included in the study – 355 assigned to the abrupt group and 342 to gradual.
After four weeks, 39.2% of participants that gradually stopped smoking were still abstinent (95% confidence interval [CI] 34.0% to 44.4%) compared with 49.0% of those that stopped smoking abruptly (95% CI 43.8% to 54.2%).
This means an increase of about 20% in quit rates for those stopping abruptly (relative risk [RR] 0.80, 95% CI 0.66 to 0.93).
The longer-term findings saw that at six months, the proportion of participants that still abstained from smoking had reduced to 15.5% in the gradual-cessation group and 22.0% in the abrupt-cessation group.
How did the researchers interpret the results?

The researchers concluded that, "Quitting smoking abruptly is more likely to lead to lasting abstinence than cutting down first, even for smokers who initially prefer to quit by gradual reduction."
Conclusion

This was a well-designed randomised controlled trial which aimed to assess whether the best method to stop smoking is by gradual reduction or an abrupt stop.
Researchers found more people in the abrupt-cessation group continued to abstain from smoking at four weeks and six months, compared with those who gradually reduced smoking.
The trial's strengths include the design, methods and analysis used. The researchers have made attempts to minimise the risk of bias, where possible.
The population sample is large, which allows for greater certainty that the findings are not purely down to chance. The follow-up period of six months allowed researchers to assess the longer-term effect of cessation methods.

As the authors state, limitations are that the sample is not representative of the UK's ethnic mix, as non-white groups formed only 6% of the trial population.
This trial addresses a major public health issue. There has been a large amount of research designed to find the best and most effective methods of smoking cessation, particularly longer-term methods.
The idea that suddenly stopping smoking may be more effective than gradually cutting down, in terms of quitting, seems plausible.

If we can consider nicotine addiction like a plaster on the skin, pulling it right off in one sudden move, rather than slowly and painfully peeling it off, could be more effective.
But when it comes to stopping smoking, one size does not fit all. It may be necessary to seek help and support from a Stop Smoking Service or GP, who can tailor a quitting method to your needs.

Pregnancy: weight control cuts complications

“Dieting in pregnancy is good for you,” according to The Independent, while the Daily Mail has warned pregnant women not to eat for two since “piling on the pounds during pregnancy” increases the risk of complications.


Both these news stories are based on a study that compared ways to manage weight during pregnancy, but did not tell women to diet or look at the effects of overeating, as the headlines implied. Instead, the research reviewed previous studies to look at how diet, exercise or a combination of the two affected maternal weight gain and the risk of health problems for babies. In particular, it found that compared to other interventions such as exercise, following a diet plan (but not a weight-loss diet) during pregnancy was more effective at reducing the amount of weight mothers gained. This had no adverse effect on the baby and reduced the risk of pre-eclampsia, diabetes, high blood pressure and premature birth.
This large study comes in the wake of concerns about the growing problem of obesity in pregnancy, which can cause serious problems for the mother and is a risk factor for later obesity in the child. It has found that dieting during pregnancy to maintain a healthy weight is safe, effective and has no effect on the baby’s birth weight, a factor which many woman worry about.
Currently, pregnant women are advised not to “eat for two” or reduce their calories, but to follow a healthy, varied diet with plenty of fruit and vegetables and a minimal intake of foods that are high in fat and sugar. Women who suspect they are overweight or obese are advised to talk to a dietitian, who will help them with a weight management programme.
Where did the story come from?

The study was carried out by researchers from several institutions in Europe, including Queen Mary University of London and the University of Birmingham. It was funded by the National Institute for Health Research’s Health Technology Assessment Programme. It was published in the peer-reviewed British Medical Journal.
Predictably, many newspapers made a meal of reporting this research, warning women not to “eat for two” even though women have been advised against doing this for several years now. The Metro’s headline that expectant mothers were being “urged to go on a diet” was also misleading. The study did not advise all women to follow a calorie-controlled diet but instead suggested that dietary interventions should be targeted at women who are obese or overweight. The paper’s photo of a pregnant woman holding weights was also misleading, since the study found diet to be more effective than exercise at reducing weight in pregnancy.
What kind of research was this?

This meta-analysis combined the results of randomised controlled trials which had looked at the effects of diet, exercise or a combination of the two on weight gain in pregnancy. Researchers also explored whether such interventions had any other effects during pregnancy and birth, and whether they affected the weight of the baby.
The researchers point out that obesity is a “growing threat” to women of childbearing age, with half the population being either overweight or obese. In Europe and the US, 20–40% of women gain more than the recommended weight during pregnancy. The researchers say that excessive weight gain during pregnancy is associated with adverse pregnancy outcomes, while for the children maternal obesity is a risk factor for obesity during childhood, which can persist into adulthood.
The authors argue that there is a need to identify safe and effective ways to help women manage their weight during pregnancy.
What did the research involve?

The authors analysed the results of 44 randomised controlled trials involving over 7,000 women.
They conducted searches of several electronic databases to find trials on the subject of pregnancy and weight. They also searched for relevant unpublished studies in sources of information such as conference databases. From these, they selected randomised controlled trials that tested the effects of dietary or lifestyle interventions on maternal and baby weight, as well as maternal and foetal outcomes.
The interventions in the trials were classified into three groups: mainly diet-based, physical activity-based, or based on both diet and physical activity. Studies were assessed for the quality of their design and methods to minimise the risk of bias.
The main outcome assessed was weight-related changes in the mother and baby, but researchers also looked at whether diet or exercise were associated with the risk of other critical pregnancy outcomes, including gestational diabetes, pre-eclampsia (a dangerous complication of pregnancy), premature delivery, stillbirth and shoulder dystocia (an emergency during childbirth where one of the baby’s shoulders becomes stuck behind the mother’s pubic bone). They summarised the strength of the evidence for these outcomes using an established system for grading evidence.
To explore possible further adverse effects, they undertook a separate search and review of the safety of diet and exercise in pregnancy, based on established methods. They analysed the data from the selected trials using standard statistical methods.
What were the basic results?

The researchers’ analysis included 44 randomised controlled trials involving 7,278 women, looking at the effects of diet, exercise or a combination of the two.
The researchers compared the outcomes seen in women who were assigned interventions and women in control groups (who were not offered any interventions). They found that:
Women who dieted, exercised or did both gained on average 1.42kg less than women in the control groups (95% confidence interval [CI] 0.95 to 1.89kg).
Dieting, exercising, or doing both had no significant effect on the baby’s birth weight (mean difference -50g, 95% CI -100 to 0g), or whether babies were large or small for gestational age (the amount of time they had been in the womb).
On its own, physical activity was associated with a reduced birth weight of 60g on average (95% CI -120 to -10g).
Diet, exercise, or both reduced the risk of pre-eclampsia (relative risk [RR] 0.74, 95% CI 0.60 to 0.92) and shoulder dystocia (RR 0.39, 95% CI 0.22 to 0.70), with no significant effect on other critically important outcomes.
Dietary intervention resulted in the largest reduction in mothers’ weight gain during pregnancy. Compared with controls, women following dietary interventions were 3.84kg lighter and had better pregnancy outcomes than with other interventions (95% CI 2.45 to 5.22kg).
The overall evidence rating for the underlying studies was reported as low to very low for important outcomes such as pre-eclampsia, gestational diabetes, gestational hypertension and preterm delivery.
How did the researchers interpret the results?

The researchers concluded that diet and exercise can reduce maternal weight gain and improve outcomes for both mother and baby, with dietary intervention being the most effective. The diets in the trials included:
a conventional balanced diet (based on an energy intake of 18–24kJ per kg of body weight)
a low-glycaemic diet with unprocessed whole grains, fruits, beans and vegetables
a diet with a maximum of 30% fat, 15–20% protein and 50–55% carbohydrate
Based on their findings, the researchers suggest that regular advice on planned nutritional intake should be provided to women from early pregnancy onwards, targeting overweight and obese women, who they say would benefit most.
Conclusion

This study has found that dieting during pregnancy to maintain a healthy weight is safe, effective and has no consequential effect on the baby’s birth weight, a factor which many women worry about.
It’s important to correct some of the inaccurate news coverage of this research. The research highlights the importance of eating healthily during pregnancy, but does not mean that all pregnant women should be put on diets. Nor does it recommend a reversal of the current advice that women should not eat for two, which has long been discouraged.
While putting on too much weight can affect a woman’s health and increase the risk of complications, gaining too little weight can also cause problems and mean the body is not storing enough fat. The current advice is not to go on a weight-loss or calorie-restricted diet during pregnancy, although a woman’s midwife or GP may have special advice if she weighs more than 100kg. Instead, current advice is based on eating a balanced diet and managing weight at an appropriate level. While it’s unlikely to make juicy headlines, the simple fact is that women should eat a normal amount and a balanced range of nutrients.
Weight gain in pregnancy varies greatly, although most pregnant women can expect to gain 8–14kg, most of it after week 20, as the baby grows and the body lays down enough fat to make breast milk after the baby is born. The medical team supporting a woman during pregnancy will monitor her changes in weight and diet, and will make appropriate suggestions to help her and her baby be as healthy as possible.

Belly Fat Dangers for Normal-Weight Women

You’ve probably heard that your belly is the most dangerous place to carry excess fat because of its link to health risks. It’s true, and now new research from the Mayo Clinic reveals that being normal weight with excess belly fat is even more risky than simply qualifying as obese. In other words, your waistline matters—a lot.

The study looked at a representative sample of the US population, which included more than 12,000 subjects ages 18 years and older. Through surveys, various facts were collected, including height, weight, waist and hip measurements, socioeconomic status, illnesses, and lab tests. That baseline data was matched to the National Death Index about 14 years later, and people with chronic obstructive pulmonary disease and cancer were excluded from the analysis.

Scientists found that subjects with normal BMIs who were apple shaped (a high waist-to-hip ratio) were more likely to die from any cause, even compared to those who were obese. In addition, this group was 2.75 times more likely to die from heart disease and twice as likely to die from any cause compared with those who had a normal BMI and a healthy waist-to-hip ratio.

The news is scary, but if you’re worried about your expanding waistline, don’t panic. First, consider which type of belly fat you’re carrying. Researchers believe the risks found in this study are tied to internal belly fat, also called visceral fat. Subcutaneous belly fat, the squishy, squeezable kind just under the surface of your skin, isn’t considered as hazardous. Visceral fat on the other hand is the deep, internal belly fat under your abdominal muscles that accumulates around your organs. It doesn’t jiggle when you walk, and it’s more dangerous because it’s associated with an increased risk of a number of health problems, including heart disease, type 2 diabetes, dementia, high blood pressure, and some cancers.

If you think you may be carrying more visceral fat, there are steps you can take to reduce it. In another recent study, Wake Forest researchers found that two habits stood out in reducing belly fat accumulation: eating more soluble fiber and engaging in moderate activity. Among more than 1,000 people studied, each 10-gram increase in soluble fiber consumed per day resulted in a 4 percent reduction in visceral fat over five years. And being regularly moderately active resulted in more than a 7 percent decrease in visceral fat build up over the same time period.

There are lots of resources here on Shape.com to help you be more active. As for soluble fiber, that’s the soft sticky kind found in oats (if you’ve ever stirred oatmeal you’ve probably see that stickiness). Other good sources are fruits, veggies, beans, and lentils. Here are five foods, which can reasonably be consumed in one day, that add up to an extra 10 grams of soluble fiber: 2 tablespoons flax seeds (2.2 g), 1 cup cooked Brussels sprouts (4 g), ½ cup black beans (1.4 g), 1 small orange (1.8 g), 1 (7”) raw carrot (1.1 g).

And there are other ways to lower your risk. Check out some of my previous posts, which include belly-fat fighting strategies like eating more raw foods, choosing good fats, reaching for more berries, and considering certain vitamins.

Women Smokers and Risk of Lethal Stroke

An ischemic stroke is the most common type of stroke, and occurs when a blood clot blocks blood flow to the brain.

But women who smoked were 17 percent more likely to suffer a bleeding (hemorrhagic) stroke than men who smoked, according to the findings, which were published in the journal Stroke.

The researchers also found evidence that men and women who smoke can significantly reduce their risk of stroke by quitting smoking.

Hormones and the way nicotine affects blood fats may explain the increased risk for bleeding strokes among women who smoke, the study authors said. They noted that women who smoke have greater increases in fats, cholesterol and triglycerides than men who smoke.

"Cigarette smoking is a major risk factor for stroke for both men and women, but fortunately, quitting smoking is a highly effective way to lower your stroke risk," study lead author Rachel Huxley, a professor in the School of Population Health at the University of Queensland, in Australia, said in a journal news release. "Tobacco-control policies should be a mainstay of primary stroke prevention programs."

Although the research showed an association between women smoking and an increased risk of hemorrhagic stroke, it did not prove a cause-and-effect relationship.

Exercise Tips For Pregnant Women

Exercising during pregnancy reduces aches and pains, caused by wear and tear on your joints, and helps your body snap back more quickly after the delivery. In addition, a good fitness plan can help temper mood swings, reduce fatigue and improve sleep. Still need convincing? Women who exercise have shorter and less intense labours.

Having said all this, it is your doctor who will tell you whether it is safe for you to exercise during your pregnancy or lie low for whatever reasons. But if you are given the green signal, here are some tips:

Select a fitness program that includes cardio, strength training, and flexibility components.

The American Pregnancy Association generally recommends that cardio training be limited to 15 to 30 minutes and should include low-impact cardiovascular activities such as brisk walking, running, elliptical, biking, or low-impact aerobics classes. Pregnant women should keep their heart rate during cardiovascular activities to no more than 140 beats per minute.

When strength training, pregnant women should be sure to train the shoulders, upper back, chest, and arms.

Stretch you hamstrings and back more than usual before and after workouts. Also ankle rotations help reduce swelling.

Though you should not be doing regular sit ups and crunches, other abdominal exercises like pelvic tilts in either a standing, seated or all fours position should be substituted.

Although recommended as part of any fitness program, warm-ups and cool-downs are particularly important during pregnancy to allow the mother’s heart rate and blood pressure to adjust in a slow, safe and controlled manner.

Shell out for new sneakers. During pregnancy, feet can increase as much as two full sizes and, perhaps even worse, the effects can be permanent! When shopping for new kicks, select a pair that provides good ankle stability and has added arch support.

It is especially important for women to remain hydrated during exercise. Experts recommend that women drink one pint of water prior to exercise and an additional cup for every 20 minutes of sustained activity to maintain optimal hydration.

Listen to your body. Exercising while pregnant results in a higher-than-normal increase in oxygen demand, meaning that you will feel tired more quickly.

Some physical activity that you should avoid if pregnant are: Avoid contact sports, avoid exercising on rough and uneven terrain, and avoid movements that strain the lower back such as lifting weights above the head or deep squats.

White bread, rice, and other carbs boost heart disease risk in women

Women who eat more white bread, white rice, pizza, and other carbohydrate-rich foods that cause blood sugar to spike are more than twice as likely to develop heart disease than women who eat less of those foods, a new study suggests.

Men who eat lots of those carbohydrates -- which have what's known as a high glycemic index -- do not have the same increased risk, however, perhaps because their bodies process the carbs differently, the researchers found.

Only carbohydrates with a high glycemic index appear to hurt the heart. Carbs with a low glycemic index -- such as fruit and pasta -- were not associated with an increased risk of heart disease, which suggests that the increased risk is caused "not by a diet high in carbohydrates, but by a diet rich in rapidly absorbed carbohydrates," says the lead author of the study, Sabina Sieri, of the Fondazione IRCCS Istituto Nazionale dei Tumori, a national institute for cancer research in Milan, Italy.
The glycemic index ranks on a scale from 1 to 100 how quickly (or slowly) carbohydrates affect your blood-sugar levels. (White bread scores 100.) Foods that rank below 55 are considered to have a low glycemic index and produce only small fluctuations in blood glucose and insulin levels; foods that rank above 70 are said to have a high glycemic index and tend to cause unhealthy spikes in blood sugar.

Health.com: 10 best foods for your heart

In the study, published this week in the Archives of Internal Medicine, Sieri and her colleagues analyzed data from a large, ongoing study of nutrition and cancer risk. The researchers surveyed roughly 48,000 Italian adults about their diets in detail, noting the amount and types of carbohydrates they consumed on a regular basis. (People with diabetes, who have abnormal levels of blood sugar and insulin, were excluded.) Not surprisingly -- the study was conducted in Italy, after all -- bread, pasta, and pizza were common sources of carbs.

Health.com: 25 diet-busting foods you should never eat
During the eight-year follow-up period, 463 people in the study -- 65 percent of them men -- experienced heart problems (including heart attacks), had angioplasty or bypass surgery, or died of heart-disease-related causes.

The women who reported eating the most carbohydrates had twice the risk of developing heart disease as their counterparts who consumed the fewest carbs.
When the researchers broke the carbs into high and low glycemic index categories, the increased risk was even more apparent: Women who ate the most high glycemic foods had about 2.25 times the risk of developing heart disease than women who consumed the fewest. (To isolate the effect of the carbs on heart health, the researchers took body weight, physical activity, saturated fat intake, smoking, and a range of other health factors into account.)

Men, by contrast, were not at increased risk for heart disease regardless of how many -- or what type of -- carbs they consumed. Although the researchers aren't certain why this is, they suggest that it may be in part because carbohydrates with a high glycemic index lower HDL (or good cholesterol) and raise triglycerides less readily in men than they do in women.
Health.com: 20 meals that won't kill your cholesterol
Previous studies have shown a similar link between glycemic index and heart disease risk, and a similar discrepancy between men and women. "We hope to be able to repeat this analysis on...more than 500,000 subjects in order to confirm our results," Sieri says.

Joanna McMillan Price, a nutritionist in Sydney, Australia, and the author of The Low GI Diet, says that the new study provides yet more evidence to support a diet that favors low versus high glycemic index foods. "That means cutting out processed carbs and choosing instead minimally processed whole grains and low-GI starchy vegetables, fruits, and legumes," she says.
Health.com: Heart-healthy recipe of the day


There are many benefits to limiting foods with a high glycemic index, Price adds. People who do so "will find their appetite easier to control, making weight control easier in turn," she says. "They will help to keep energy and mood steady over the day, and they reduce their risk of several chronic diseases including diabetes, heart disease, and certain cancers."
According to Price, the best low glycemic index foods are whole-grain breads, barley, quinoa, beans and chickpeas, low-fat dairy products, fruit, and sweet potatoes.
Health.com: Carbs that help you lose weight

Why Women Find it Harder to Quit Smoking

"When you look at it by gender, you see this big difference," said study researcher Kelly Cosgrove, an assistant professor of psychiatry at Yale University School of Medicine.

The findings are important because the main treatments for people who want to quit smoking are nicotine-replacement therapies, such as nicotine patches and gums. The study suggests women smokers may benefit more from other types of treatment that don't involve nicotine, including behavioral therapies, such as exercise or relaxation techniques, and non-nicotine containing medications, Cosgrove said.

Elements of smoking not related to nicotine, such as the smell and act of holding a cigarette, may play a greater role in fueling the habit of women smokers, compared with men, Cosgrove said.

Locating nicotine receptors

Cosgrove and colleagues scanned the brains of 52 men and 58 women, about half of whom were smokers. The researchers examined nicotine receptors in the brain by using a radioactive marker that binds specifically to an important group of receptors that are primarily responsible for the body's physical dependence on nicotine, Cosgrove said.

Smokers in the study had abstained from smoking for a week so that their nicotine receptors would be free to bind to the marker used for imaging.

The researchers found that male smokers had about 16 percent more nicotine receptors in an area of their brain known as the striatum, 17 percent more in the cerebellum, and 13 to 17 percent more in the cortical region, or outside layer, of the brain compared with male nonsmokers. Female smokers, on the other hand, had similar numbers of nicotine receptors in these brain regions.

Why are female brains different?

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in N.Y., agreed more attention should be paid to non-nicotine related smoking therapies.

"You can replace all the nicotine you want, and people might still want to smoke," Horovitz said. For instance, smoking is a big stress reliever for some people. Even the act of deep breathing is a part of the habit, and breathing exercises may help smokers because they mimic puffing a cigarette, Horovitz said.

The reason for the sex difference seen in the study is not known, but it may have something to do with levels of the hormone progesterone. Levels of this hormone fluctuate in females depending on the stage of the menstrual cycle, and are much higher after ovulation. The study found higher levels of progesterone were associated with a lower number of available nicotine receptors, the researchers said, suggesting progesterone may indirectly block these receptors.

The study is published in the April issue of Archives of General Psychiatry.

Why Women Need Fat

It's a common misconception—oh, don't eat that, it has a lot of fat in it. Fitness fiends and non-fitness fiends alike assume women should never have any fat at all, but authors William D. Lassek, M.D. and Steven J. C. Gaulin, Ph.D. will have to disagree. In their book, Why Women Need Fat: How 'Healthy' Food Makes Us Gain Excess Weight and the surprising solution to Losing It Forever, the two discuss just that--why women need fat, plus the kinds of fat they should be consuming daily.

"The idea that all fat is bad and unhealthy seems to be widespread, whether it comes in our diets or is part of our bodies. One reason for this is that the label of every food product we buy starts off by listing its (usually high) percentage of our daily 'allowance' of fat," the authors say. "And most women, even many who are quite thin, would like to have less fat on their bodies. But in both cases—bodies and food—some kinds of fat are beneficial for health, while others can be unhealthy."

We caught up with Lassek and Gaulin to reveal more fat facts you need to know, so when you start consuming this fat that they speak of, you're doing it the right way.

SHAPE: Tell us about fat.
LASSEK AND GAULIN (LG): Fat comes in three forms: saturated, monounsaturated, and polyunsaturated. Most of us have heard that saturated fat is very unhealthy, but many researchers are now questioning whether this is true. Monounsaturated fat, like that in olive and canola oil, is linked with better health. Polyunsaturated fats are the only type of fat that we have to get from our diet. These come in two forms, omega-3 and omega-6, and both are important.

While almost everyone agrees that having plenty of omega-3 fats is beneficial, there is growing evidence that too much omega-6 fat may not be good for weight or health. Different types of dietary fat are connected to different types of body fat. Higher levels of omega-6 are linked to higher levels of unhealthy belly fat, while higher omega-3 is linked to the healthier fat in the legs and hips. so when it comes to fat, we need to "do nuance."

SHAPE: So why do women need fat?
LG: While women are able to undertake any kind of work or play they want to, their bodies have been designed by evolution to be very, very good at having children, whether they choose to or not. All of these children are very unique in having brains that are seven times larger than would be expected for other animals our size. This means that women's bodies have to be able to provide the building blocks for these large brains during their pregnancies and while nursing their children—building blocks that are stored in women's fat.

The most critical brain-building block is the omega-3 fat called DHA, which makes up about 10 percent of our brain not counting water. Since our bodies cannot make omega-3 fat, it has to come from our diet. During pregnancy and while nursing, most of this DHA comes from a woman's stored body fat, and this is why women need to have so much more body fat than other animals (about 38 pounds of fat in a woman weighing 120 pounds). So women have an undeniable need for fat in their bodies and fat in their diets.

SHAPE: How much fat should we get daily?
LG: It's not the amount of fat that, but the kind of fat. Our bodies can make saturated and monounsaturated fat out of sugar or starch, so we don't really have a minimum need for these as long as we have plenty of carbs. However, our bodies cannot make the polyunsaturated fats that we need for our brains, so these have to come from our diet. These polyunsaturated fats are considered "essential." Both types of essential fats—omega-3 and omega-6—are needed; they play a number of important roles, especially in the cells in our brains.

SHAPE: In our fat consumption, do age and life stage play a role?
LG: Having plenty of omega-3 fat is important for every life stage. For women who may want to have children in the future, a diet high in omega-3 is especially important in order to build up the DHA content of their body fat, because that fat is where most of the DHA will come from when they are pregnant and nursing.

Since there is some evidence that omega-3 helps muscles work better, more active women will likely benefit from having more in their diets. For older women, omega-3 is important for good health and to reduce the risk of Alzheimer's disease. For infants and children, getting enough omega-3 fat is especially important, since their bodies and brains are actively growing and developing.

SHAPE: Where can we find "good fats?"
LG: Good fats are fats high in omega-3. DHA and EPA are the most important and active forms of omega-3, and the most abundant source for both is fish and seafood, especially oily fish. Just three ounces of wild-caught Atlantic salmon has 948 milligrams of DHA and 273 milligrams of EPA. The same amount of canned tuna fish has 190 milligrams of DHA and 40 of EPA, and shrimp have a bit less. Unfortunately, all fish and seafood are also contaminated with mercury, a brain poison, and the FDA advises that women and children have no more than 12 ounces of fish per week, limited to those which have lower levels of mercury (we have a list in our book).

Fish oil capsules or liquid can provide an additional and safer source of DHA and EPA because the oils are usually distilled to remove mercury and other impurities, and DHA from algae is available for those who do not eat fish. The basic form of omega-3, alpha-linolenic acid, is also good because it can turn into EPA and DHA in our bodies, though not very efficiently. This is found in all green plants, but the best sources are flaxseeds and walnuts, and flaxseed, canola, and walnut oils. Monounsaturated fats, like those in olive and canola oil, also seem to be beneficial for health.

SHAPE: What about "bad fats?" What should we stay away from?
LG: Our current problem is that we have way, way too much omega-6 in our diets. And because our bodies "know" that these fats are essential, it holds on to them. These oils are found mainly in fried foods such as like chips, fries, and commercial baked goods. They are also added to other processed foods to increase the amount of fat, since fat makes foods taste better. As much as possible, limit fast foods, restaurant foods, and processed foods from the supermarket, because these foods tend to have a lot of omega-6 fat.

The second kind of omega-6 that we get too much of is arachidonic acid, and this is found in meat and eggs from animals (especially poultry) fed on corn and other grains, which are the kinds of meats you usually find in supermarkets.

SHAPE: How important is exercise when consuming the good fats?
LG: There seems to be a positive synergy between exercise and omega-3 fats. Women who exercise more tend to have higher levels of omega-3 in their blood, and those with higher omega-3 levels seem to have a better response to exercise. The amount of omega-3 DHA in the membranes of muscle cells is linked with better efficiency and endurance. Increasing exercise and omega-3 levels together may also help women to lose excess weight.

HOME>HEALTH 5 Weight Loss Tips Every Petite Woman Should Know

The New Year brings new resolutions to slim down and shape up, but if you are one of the 50 percent of women in the U.S. classified as petite - 5'4? or under - you face unique challenges when trying to lose weight.

Fitness expert Jim Karas wrote his new book, The Petite Advantage Diet, to help shorter women left wondering, in frustration, why regular diets don't work for them, as they watch their taller friends drop the pounds.

Karas appeared on " Good Morning America" today to share his top diet and exercise tips for petite women.

1) Allow Yourself Carbs

People forget that carbohydrates are not just breads and pasta, but items like fruits and vegetables too, Karas says.  Healthy carbs, especially those with a high water content, are needed to help people stay full and lean in the midsection.

2) Watch the Small Stuff

Karas estimates petite women who overeat by as few as 28 calories a day will gain 30 pounds over the course of one decade.  A 45-year-old woman who weighs 160 pounds and is 5'9," for example, can eat 2,013 calories per day to maintain her weight.  A petite, 5'3? woman of the same weight and age would only be able to consume 1,973 per day without gaining weight.

If the petite woman were to take in those extra 40 calories per day, she'd gain 4.2 pounds of fat each year, which would mean 42 pounds each decade and an extra 128 pounds over the course of 30 years.

3) Eat High-Calorie and High-Fat Foods Sparingly

Karas says petite women should watch out for three foods in particular when counting their calories: olive oil, avocado and juice.

Just one tablespoon of olive oil, for instance, contains 120 calories and is 100 percent fat, so Karas recommends using it sparingly, no more than one serving per day.  Juice, meanwhile, has 25 percent more calories than soda and twice as many calories as liquid sports drinks, so petite women should watch their intake.  Commercial juice products are also pasteurized, which kills valuable nutrients and vitamins.

4) Swap Your Meals

Eaters in the U.S. typically start the day with their smallest meal, breakfast, and then work their way up to the largest, dinner.  Petite woman in particular, Kass says, should do just the opposite.  To start off, he recommends flipping breakfast and lunch servings in order to better balance the day calorie-wise.

5) Skip the Treadmill, Pick Up the Weights

Karas says cardio can actually cause petite women to gain weight because it increases their appetites.  Instead, petite women should focus on strength training, which fulfills their cardio needs while also increasing their caloric burn, enhancing their posture and strengthening and flattening their core muscles.

45 best health tips ever

We've done the legwork for you and here they are: the 45 best health tips. Make that 46 - taking the time to read this tops the list.

1. Copy your kitty: Learn to do stretching exercises when you wake up. It boosts circulation and digestion, and eases back pain.

2. Don’t skip breakfast. Studies show that eating a proper breakfast is one of the most positive things you can do if you are trying to lose weight. Breakfast skippers tend to gain weight. A balanced breakfast includes fresh fruit or fruit juice, a high-fibre breakfast cereal, low-fat milk or yoghurt, wholewheat toast, and a boiled egg.

3. Brush up on hygiene. Many people don't know how to brush their teeth properly. Improper brushing can cause as much damage to the teeth and gums as not brushing at all. Lots of people don’t brush for long enough, don’t floss and don’t see a dentist regularly. Hold your toothbrush in the same way that would hold a pencil, and brush for at least two minutes.

This includes brushing the teeth, the junction of the teeth and gums, the tongue and the roof of the mouth. And you don't need a fancy, angled toothbrush – just a sturdy, soft-bristled one that you replace each month.

4. Neurobics for your mind. Get your brain fizzing with energy. American researchers coined the term ‘neurobics’ for tasks which activate the brain's own biochemical pathways and to bring new pathways online that can help to strengthen or preserve brain circuits.

Brush your teeth with your ‘other’ hand, take a new route to work or choose your clothes based on sense of touch rather than sight. People with mental agility tend to have lower rates of Alzheimer's disease and age-related mental decline.

5. Get what you give! Always giving and never taking? This is the short road to compassion fatigue. Give to yourself and receive from others, otherwise you’ll get to a point where you have nothing left to give. And hey, if you can’t receive from others, how can you expect them to receive from you?

Read: Mind aerobics

6. Get spiritual. A study conducted by the formidably sober and scientific Harvard University found that patients who were prayed for recovered quicker than those who weren’t, even if they weren’t aware of the prayer.

7. Get smelly. Garlic, onions, spring onions and leeks all contain stuff that’s good for you. A study at the Child’s Health Institute in Cape Town found that eating raw garlic helped fight serious childhood infections. Heat destroys these properties, so eat yours raw, wash it down with fruit juice or, if you’re a sissy, have it in tablet form.

8. Knock one back. A glass of red wine a day is good for you. A number of studies have found this, but a recent one found that the polyphenols (a type of antioxidant) in green tea, red wine and olives may also help protect you against breast cancer. It’s thought that the antioxidants help protect you from environmental carcinogens such as passive tobacco smoke.

9. Bone up daily. Get your daily calcium by popping a tab, chugging milk or eating yoghurt. It’ll keep your bones strong. Remember that your bone density declines after the age of 30. You need at least 200 milligrams daily, which you should combine with magnesium, or it simply won’t be absorbed.

10. Berries for your belly. Blueberries, strawberries and raspberries contain plant nutrients known as anthocyanidins, which are powerful antioxidants. Blueberries rival grapes in concentrations of resveratrol – the antioxidant compound found in red wine that has assumed near mythological proportions. Resveratrol is believed to help protect against heart disease and cancer.

11. Curry favour. Hot, spicy foods containing chillies or cayenne pepper trigger endorphins, the feel-good hormones. Endorphins have a powerful, almost narcotic, effect and make you feel good after exercising. But go easy on the lamb, pork and mutton and the high-fat, creamy dishes served in many Indian restaurants.

12. Cut out herbs before ops. Some herbal supplements – from the popular St John's Wort and ginkgo biloba to garlic, ginger, ginseng and feverfew – can cause increased bleeding during surgery, warn surgeons. It may be wise to stop taking all medication, including herbal supplements, at least two weeks before surgery, and inform your surgeon about your herbal use.

13. I say tomato. Tomato is a superstar in the fruit and veggie pantheon. Tomatoes contain lycopene, a powerful cancer fighter. They’re also rich in vitamin C. The good news is that cooked tomatoes are also nutritious, so use them in pasta, soups and casseroles, as well as in salads.

The British Thoracic Society says that tomatoes and apples can reduce your risk of asthma and chronic lung diseases. Both contain the antioxidant quercetin. To enjoy the benefits, eat five apples a week or a tomato every other day.

14. Eat your stress away. Prevent low blood sugar as it stresses you out. Eat regular and small healthy meals and keep fruit and veggies handy. Herbal teas will also soothe your frazzled nerves.

Eating unrefined carbohydrates, nuts and bananas boosts the formation of serotonin, another feel-good drug. Small amounts of protein containing the amino acid tryptamine can give you a boost when stress tires you out.

15. Load up on vitamin C.We need at least 90 mg of vitamin C per day and the best way to get this is by eating at least five servings of fresh fruit and vegetables every day. So hit the oranges and guavas!

16. No folly in folic acid. Folic acid should be taken regularly by all pregnant mums and people with a low immunity to disease. Folic acid prevents spina bifida in unborn babies and can play a role in cancer prevention. It is found in green leafy vegetables, liver, fruit and bran.

17. A for Away. This vitamin, and beta carotene, help to boost immunity against disease. It also assists in the healing process of diseases such as measles and is recommended by the WHO. Good natural sources of vitamin A are kidneys, liver, dairy products, green and yellow vegetables, pawpaw, mangoes, chilli pepper, red sorrel and red palm oil.

18. Pure water. Don’t have soft drinks or energy drinks while you're exercising. Stay properly hydrated by drinking enough water during your workout (just don't overdo things, as drinking too much water can also be dangerous).

While you might need energy drinks for long-distance running, in shorter exercise sessions in the gym, your body will burn the glucose from the soft drink first, before starting to burn body fat. Same goes for eating sweets.

19. GI, Jane. Carbohydrates with a high glycaemic index, such as bread, sugar, honey and grain-based food will give instant energy and accelerate your metabolism. If you’re trying to burn fat, stick to beans, rice, pasta, lentils, peas, soya beans and oat bran, all of which have a low GI count.

20. Mindful living. You've probably heard the old adage that life's too short to stuff a mushroom. But perhaps you should consider the opposite: that life's simply too short NOT to focus on the simple tasks. By slowing down and concentrating on basic things, you'll clear your mind of everything that worries you.

Really concentrate on sensations and experiences again: observe the rough texture of a strawberry's skin as you touch it, and taste the sweet-sour juice as you bite into the fruit; when your partner strokes your hand, pay careful attention to the sensation on your skin; and learn to really focus on simple tasks while doing them, whether it's flowering plants or ironing your clothes.


21. The secret of stretching. When you stretch, ease your body into position until you feel the stretch and hold it for about 25 seconds. Breathe deeply to help your body move oxygen-rich blood to those sore muscles. Don't bounce or force yourself into an uncomfortable position.

22. Do your weights workout first. Experts say weight training should be done first, because it's a higher intensity exercise compared to cardio. Your body is better able to handle weight training early in the workout because you're fresh and you have the energy you need to work it.

Conversely, cardiovascular exercise should be the last thing you do at the gym, because it helps your body recover by increasing blood flow to the muscles, and flushing out lactic acid, which builds up in the muscles while you're weight training. It’s the lactic acid that makes your muscles feel stiff and sore.

23. Burn fat during intervals. To improve your fitness quickly and lose weight, harness the joys of interval training. Set the treadmill or step machine on the interval programme, where your speed and workload varies from minute to minute. Build up gradually, every minute and return to the starting speed. Repeat this routine. Not only will it be less monotonous, but you can train for a shorter time and achieve greater results.

24. Your dirtiest foot forward. If your ankles, knees, and hips ache from running on pavement, head for the dirt. Soft trails or graded roads are a lot easier on your joints than the hard stuff. Also, dirt surfaces tend to be uneven, forcing you to slow down a bit and focus on where to put your feet – great for agility and concentration.

25. Burn the boredom, blast the lard. Rev up your metabolism by alternating your speed and intensity during aerobic workouts. Not only should you alternate your routine to prevent burnout or boredom, but to give your body a jolt.

If you normally walk at 6.5km/h on the treadmill or take 15 minutes to walk a km, up the pace by going at 8km/h for a minute or so during your workout. Do this every five minutes or so. Each time you work out, increase your bouts of speed in small increments.

26. Cool off without a beer. Don’t eat carbohydrates for at least an hour after exercise. This will force your body to break down body fat, rather than using the food you ingest. Stick to fruit and fluids during that hour, but avoid beer.

27. ‘Okay, now do 100 of those’. Instead of flailing away at gym, enlist the help – even temporarily – of a personal trainer. Make sure you learn to breathe properly and to do the exercises the right way. You’ll get more of a workout while spending less time at the gym.

28. Stop fuming. Don’t smoke and if you smoke already, do everything in your power to quit. Don’t buy into that my-granny-smoked-and-lived-to-be-90 crud – not even the tobacco giants believe it. Apart from the well-known risks of heart disease and cancer, orthopaedic surgeons have found that smoking accelerates bone density loss and constricts blood flow. So you could live to be a 90-year-old amputee who smells of stale tobacco smoke. Unsexy.

29. Ask about Mad Aunt Edith. Find out your family history. You need to know if there are any inherited diseases prowling your gene pool. According to the Mayo Clinic, USA, finding out what your grandparents died of can provide useful – even lifesaving – information about what’s in store for you. And be candid, not coy: 25% of the children of alcoholics become alcoholics themselves.

30. Do self-checks. Do regular self-examinations of your breasts. Most partners are more than happy to help, not just because breast cancer is the most common cancer among SA women. The best time to examine your breasts is in the week after your period.

31. My smear campaign. Have a pap smear once a year. Not on our list of favourite things, but it’s vital. Cervical cancer kills 200 000 women a year and it’s the most prevalent form of cancer among black women, affecting more than 30 percent.

But the chances of survival are nearly 100 percent if it’s detected early. Be particularly careful if you became sexually active at an early age, have had multiple sex partners or smoke.

32. Understand hormones. Recent research suggests that short-term (less than five years) use of HRT is not associated with an increase in the risk of breast cancer, but that using it for more than ten years might be. Breast cancer is detected earlier in women using HRT, as they are more alert to the disease than other women.

32. Beat the sneezes. There are more than 240 allergens, some rare and others very common. If you’re a sneezer due to pollen: close your car’s windows while driving, rather switch on the internal fan (drawing in air from the outside), and avoid being outdoors between 5am and 10 am when pollen counts are at their highest; stick to holidays in areas with low pollen counts, such as the seaside and stay away from freshly cut grass.

33. Doggone. If you’re allergic to your cat, dog, budgie or pet piglet, stop suffering the ravages of animal dander: Install an air filter in your home.

Keep your pet outside as much as possible and brush him outside of the home to remove loose hair and other allergens. Better yet, ask someone else to do so.

34. Asthma-friendly sports. Swimming is the most asthma-friendly sport of all, but cycling, canoeing, fishing, sailing and walking are also good, according to the experts.

Asthma need not hinder peak performance in sport. 1% of the US Olympic team were asthmatics – and between them they won 41 medals.

35. Deep heat. Sun rays can burn even through thick glass, and under water. Up to 35% of UVB rays and 85% of UVA rays penetrate thick glass, while 50% of UVB rays and 75% of UVA rays penetrate a meter of water and wet cotton clothing.

Which means you’ll need sunscreen while driving your car on holiday, and water resistant block if you’re swimming.

36. Fragrant ageing. Stay away from perfumed or flavoured suntan lotions which smell of coconut oil or orange if you want your skin to stay young. These lotions contain psoralen, which speeds up the ageing process. Rather use a fake-tan lotion. Avoid sun beds, which are as bad as the sun itself.

37. Sunscreen can be a smokescreen. Sunscreen is unlikely to stop you from being sunburned, or to reduce your risk of developing skin cancer. That’s because most people don’t apply it properly, and stay in the sun too long.

The solution? Slather on sunscreen daily and reapply it often, especially if you’ve been in the water. How much? At least enough to fill a shot glass.

38. Laugh and cry. Having a good sob is reputed to be good for you. So is laughter, which has been shown to help heal bodies, as well as broken hearts. Studies in Japan indicate that laughter boosts the immune system and helps the body shake off allergic reactions.

39. It ain’t over till it’s over. End relationships that no longer work for you, as you could be spending time in a dead end. Rather head for more meaningful things. You could be missing opportunities while you’re stuck in a meaningless rut, trying to breathe life into something that is long gone.

40. Strong people go for help. Ask for assistance. Gnashing your teeth in the dark will not get you extra brownie points. It is a sign of strength to ask for assistance and people will respect you for it. If there is a relationship problem, the one who refuses to go for help is usually the one with whom the problem lies to begin with.

41. Save steamy scenes for the bedroom. Showering or bathing in water that’s too hot will dry out your skin and cause it to age prematurely. Warm water is much better.

Apply moisturiser while your skin is still damp – it’ll be absorbed more easily. Adding a little olive oil to your bath with help keep your skin moisturised too.

42. Here’s the rub. Improve your circulation and help your lymph glands to drain by the way you towel off. Helping your lymph glands function can help prevent them becoming infected.

When drying off your limbs and torso, brush towards the groin on your legs and towards the armpits on your upper body. You can do the same during gentle massage with your partner.

43. Sugar-coated. More than three million South Africans suffer from type 2 diabetes, and the incidence is increasing – with new patients getting younger. New studies show this type of diabetes is often part of a metabolic syndrome (X Syndrome), which includes high blood pressure and other risk factors for heart disease.

More than 80% of type 2 diabetics die of heart disease, so make sure you control your glucose levels, and watch your blood pressure and cholesterol counts.

44. Relax, it’s only sex. Stress and sex make bad bedfellows, it seems. A US survey showed that stress, kids and work are main factors to dampen libido. With the advent of technology that allows us to work from home, the lines between our jobs and our personal lives have become blurred.

People work longer hours, commutes are longer and work pervades all aspects of our lives, including our sexual relationships. Put nooky and intimacy on the agenda, just like everything else.

45. Good night, sweetheart. Rest heals the body and has been shown to lessen the risk of heart trouble and psychological problems.