My Menopause Magazine
Body Fat
The Good, The Bad or The Ugly
10
Benefits of Estrogen
N 34 o
Tips For Your Lips:
How to Keep Them Kissable Can Simple Stretching
Improve Menopause Symptoms?
If taken in The Estrogen Window
Tosca Reno
How to Eat Clean, Live Healthy and Lose Weight
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3 Questions to Ask About Your Skincare
Is your skincare both effective and healthy?
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The Hot Years
No 34
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My Menopause Magazine
In this Issue: Tosca Kennedy
Reno Explains How to Eat Clean, Live Healthy and Lose Weight
Top 10 Benefits of Estrogen
The Flat Belly Work Out
Dispelling the Myth About Estrogen and Breast Cancer
Body Fat: The Good, The Bad or The Ugly
Simple Stretching to Improve Menopause Symptoms
3 Questions to Ask About Your Skin Care
Tips For More Kissable Lips
Recipe: Orange Spinach Wild Salmon
Editorial
The Hot Years
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September is
Menopause Awareness Month I
t’s Menopause Awareness Month and I thought I’d share why I started The Hot Years and why making this helpful to you is so important to me – and to you! I was born in a small town in Texas at a time when the local wisdom was, “A fat baby was a healthy baby”. So my parents and my grandparents made sure I was very healthy.
They fed me until I was so heavy that at age 2 1/2 I was photographed in front of the Sears building in my husky pants, and that photo was placed on the front page of the Galveston Daily News under the Header: Mighty Might: The Fattest Kid in the County. Every-
thing I did to try and change my weight failed, until I met the person who really knew how to make this change happen. Coach Mayfield helped me under-
The right coach is one of the fastest ways to achieve essential results stand what would make the difference - diet, nutrition and goal setting, as well as basketball. That was the beginning of me being my ideal weight for the
Editorial
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rest of my life. It also taught me that the right coach is one of the fastest ways to achieve essential results. After medical school at the University of Texas Medical Branch, I did my Ob/ Gyn residency at Emory University in Atlanta. During the summer between my 3rd and 4th years of post medical school training, I noticed a lump in my neck the size of my fist. My doctors thought it was cancer and I had scans and a lot of tests. One doctor told me I might need part of my jaw and half of my tongue removed. While waiting to have a biopsy done, Dr. Thompson, the Ob/Gyn Chairman, took me out on his sailboat on Lake Lanier. He said, “Stay calm - it might not be cancer... they couldn’t know until they had a tissue diagnosis.” Luck was on my side; it turned out to be a rare benign tumor. But I wasn’t out of the woods yet. There was a 2 out of 3 chance that the surgery to remove the tumor would leave me unable to speak. I learned really clearly what
Everybody was guessing and nobody knew for sure what to do
The standard of care was to not to give estrogen it means to be helpless and feel out of control, and how much getting the wrong information can scare you and cause suffering. I also learned what it feels like to be afraid of treatment. I had a great doctor who saved my voice. Most importantly, I felt my voice had been spared for a reason; and I committed to use my voice to make a huge difference in women’s health. After completing my residency, Harvard offered me a Fellowship to specialize in infertility, women’s hormones and menopause. As one of the leading infertility experts in the world, I performed one of the first successful in vitro fertilization procedures, wrote dozens of research papers, and was even written about in People magazine for helping gorillas conceive at the Boston zoo. Then, shortly after a study inaccurately reported that estrogen causes women in menopause to get breast cancer, heart disease and dementia, my wife Sharon went through surgery that threw her into early menopause. Her doctors were concerned about giving
Editorial
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her estrogen because the standard of care was to not give estrogen. Everybody was guessing and nobody knew for sure what to do. I was committed to knowing the truth with a powerful personal commitment to getting this right for my wife - and ultimately for all of my patients. Right then and there, I switched my focus
Visit MenopauseQuiz. com for a free quiz to discover your menopause score and research from infertility to answering the question of “what is the safest and most effective treatment for going through menopause.” There was a critical imperative to get this right to help my wife. I also knew that all my patients - and thousands of other women approaching and in menopause - needed this help and information too. Making sure you get accurate and clear information about your health is critical for you – and a commitment from me. Four years ago my wife was diagnosed with pancreatic cancer. That is a real-
ly serious disease. I pulled back from most of my patient care to help her find the right treatment since even here, there is limited information and confusion about the right path. While supporting her through this treatment that ultimately was curative, it was also important to continue helping my patients with the best and most current information and research. Then I realized I could help even more women through online education. My goal is to help women in The Hot Years feel healthy, happy and hormonally balanced. If you would like to discover how much your menopause symptoms impact your health, your happiness and your life, take the Menopause Quiz, and watch your email for a summary of your results and some suggestions on next steps to support you in navigating “the change” for a healthy, vibrant life.
The Hot Years Featured Article
The Hot Years
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Tosca Reno
Explains How to Eat Clean, Live Healthy and Lose Weight Discover how this New York Times Best Selling Author became a Bikini Champion at 52 and How You Can Look and Feel Fabulous After 50
T
osca Reno is a New York Times bestselling author and founder of The Eat-Clean Diet. She’s also a health revolution, health and wellness transformation coach, a motivational speaker, and star of Gemini – an award-winning reality TV show. Dr. Mache Seibel: Tosca, you are a physique competitor and a mother of four. You’ve graced the covers of many magazines, won your class in bikini at the age of 52, and proven that sexy, smart, strong and inspirational don’t depend on your age. Tosca Kennedy: Thank you so much Mache for inviting me.
The Hot Years Featured Article
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Dr. Mache: Sugar is the new salt. There’s been talk about all of the hidden sugars that are in food. Why is sugar one of the worst ingredients of all time?
it becomes part of your life and you can hardly live without it. And sugar isn’t labeled as a dangerous drug. We know that the other ones are. So we get into trouble.
Tosca: I think sugar’s true danger lies in the fact that most people don’t think it’s so bad; and we don’t realize that sugar hides in much of our foods, particularly, processed foods. I hear people say things like, “Sugar couldn’t possibly be that bad.”
I have found that if I do not start my client with my program called “Strike Sugar,” that it’s very, very difficult to become successful in trying to lose weight or make any kind of physical or wellness-type of changes. It’s the very first thing I encourage everyone to do when we get started working together.
I believe sugar is far more dangerous than heroin and cocaine
Dr. Mache: It was only about fifty years ago when people ate 20 pounds of sugar per year. Today, the average person is eating their weight in sugar every year, about 150 pounds.
Dr. Mache: No wonder. Mary Poppins told us, “A spoonful of sugar helps the medicine go down.” Tosca: They told us that, exactly! But I believe sugar is far more dangerous than heroin and cocaine. I say that because heroin and cocaine and sugar alike are crystalline, white powder. We ingest them and we get a high. We crash, and then we want more. The problem with sugar is that you don’t recognize that it’s everywhere. You don’t recognize the addiction it’s building, and you don’t recognize that
Tosca: That cannot be a good outcome on anyone. I ask people: “What is the one food you cannot live without? And that’s where we begin. This is where I ask them to have courage and get it out of their system. Dr. Mache: This is tough love; giving up the thing you miss the most, in order to go forward. Tosca: I think it is partly because people have become so addicted to wanting sugar that it’s more of an emotional support, turning to that food to find comfort.
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Dr. Mache: People want comfort because they are stressed all the time. I know if I control my sugar, there’s a lot less need for sugar because my body is in a constant state. If I eat sugar I want more sugar because I get high from it and then I get low from it. What would you say are the 3 to 5 top sugar offenders that people should be on the lookout for? Tosca: Let’s start with food. Wine is just a sugar addiction. I also think that refined or processed cereals we think we are eating in the name of health are all just sugar. I don’t mean the sugar added to it; the body translates refined grain into sugar through the process of ingesting and digesting it. And then the obvious ones - cakes, cookies, candies and chocolates are sugars. Dr. Mache: I would toss in sodas as the fourth one. Tosca: Yeah. And white bread. Dr. Mache: How can we detox from sugar. What does the average person do? Tosca: This is why I built the “Strike Sugar” program. I don’t think you can detox from sugar in just a matter of days. I think you need a solid 4-week program. It’s not impossible that when you follow a structure such as
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the one I created, you have a guideline, you have exactly what you eat every day, you have menus, recipes, you have motivation, you have support, and you have the reasons why. So, to me, that is the way to overcome this frenetic desire for sugar. I also talk about the various supplements you can use, like L-Glutamine that can help kill sugar cravings. Dr. Mache: How does that work? Tosca: It feeds the five pounds of friendly bacteria in the gut – our microbiome. We have to teach those bacteria to want a fuel other than sugar. So a program like “Strike Sugar” can help you do that because all the sugar is removed. Now, does the food taste like cardboard? No. Is it easy to make? Yes. Does it satisfy? Absolutely. Will you detox sugar? Indeed. It’s just a temporary thing, so we do the four weeks, we cleanse and then we get back into re-introduction. Dr. Mache: You’re saying it’s possible to retrain our gut bacteria. If you feed healthy ingredients into your intestinal tract, i.e., you eat the right foods, you’re going to get rid of some of the bad bacteria and get more of the good bacteria so it’s balanced in a way that sustains and supports
your health and well-being. You can be healthier and actually create an environment in your stomach that’s healthy for all of your body. Tosca: Right. And that translates into your wellness through lack of fierce cravings for a soda or chocolates. We have less inflammation, less bloat, more energy, better sleep and less irritability. The skin clears up and myriads of other positive changes occur. Some people have reported they had more energy than their children, for example. Unfortunately, sugar is also a huge problem for cancers; it’s a perfect place for cancers to arise. Dr. Mache: You’re saying it feeds the cancer, and also the inflammation and suppresses the immune system, which is trying to internally fight off cancers. So you’re setting yourself up for a bad outcome. Tosca: Right. Dr. Mache: Correcting the gut bacterial balance also helps keep bowel movements more regular and auto cleanses your GI tract a little bit. Tosca: Oh, absolutely, that’s part of it. It’s amazing; everything is so beautifully linked in the body, and it all starts with what we put in the mouth.
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Dr. Mache: Food is the fuel for every cell. You figured out some key foods that need to be adjusted or stopped. You figured out that there is a systematic nutritional way to do it, and it helps to have a little bit of training to go with it because probably a little exercise could be helpful here. Tosca: Undoubtedly. Exercise is one of the key ways to manage blood sugar because we know that the muscles require glucose for activity. So when we exercise we create a condition in the body called glucose sink. The muscle cells open up like little funnels that gobble up any circulating glucose because that’s the fuel they need to create movement. So, physical exercise puts the glucose sink into the body and melts all that sugar. It’s a beautiful way to help manage blood sugar levels. According to a wonderful book by Dr. John Ratey called Spark, we know that physical exercise can also change the condition of the brain. We know that if we exercise for 30 minutes at 65% or higher of our maximum heart rate for at least six days a week, we can do something very profound to the nature of the brain to help preserve its stability and function. It’s like pouring Miracle Grow on the brain, with the brain-derived neurotrophic factors that help increase blood flow in the brain, which makes communication more powerful.
Why that’s important in relation to sugar and exercise is because we now know that Alzheimer’s and dementia are termed diabetes type 3, which are conditions of inability to absorb blood sugar correctly and sufficiently by the brain. Dr. Mache: So when you’re exercising, you’re building muscles that are going to soak up more sugar, which makes you move better, feel stronger, and maintain muscle mass. The second thing you said, is when you exercise at 65% or more of maximum heart rate (for most people that’s a heart rate of about 150 to 180 or roughly 220 minus your age) six of the seven days per week, it will improve your brain. You want to talk with your trainer, doctor, or someone to get the right heart rate for you. So, you’re of the belief that just counting calories is not sufficient. Why doesn’t calorie-counting work? Tosca: Calorie counting, to me it seems to ignore the most important piece, which is the quality of food you’re eating. If you’re only focusing on the calories, then you will treat 100 calories from poor foods and from healthy foods the same. For example, 100 calories from an apple is healthy; but 100 calories from a do-
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nut is not. So, when we simply focus on the calories, we miss the point altogether and we think that the calories alone will keep us lean, but we know that’s not true. Sugar induces inflammation, it induces mineral loss, it induces illness, weight gain. Dr. Mache: So you’re not a fan of the Twinkie Diet? Tosca: I’m not a fan of the Twinkie Diet. No! I’m a fan of The Eat-Clean Diet. Dr. Mache: What is The Eat-Clean Diet? Tell me about that. Tosca: Well, it’s interesting. Eating clean now has become part of the vernacular. Although I envisioned it a certain way, many people interpret it as eating no processed foods or eating close to the earth. But here’s what
Eating clean is eating whole nutrients that are from well sourced, properly prepared foods, eaten in season
I, as the founder, intended it to be, which is eating whole nutrients that are well sourced, properly prepared foods, eaten in season. I like to avoid the sugars we’ve been talking about and the 6000 or so new processed foods that arrive on the market every year. I eat five to six smaller meals a day using the macro nutrient ratio of about 30% proteins, 30% healthy fat and 40% complex carbohydrates of which 20% comes from greens and 20% from fruits and whole grains. That’s eating clean; six small meals a day, carry your food with you, avoid the processed foods and eat whole, nutrient-dense, wellsourced, properly-prepared foods. Dr. Mache: I think that a lot of people get frustrated because processed foods last so long. For instance, a Twinkie will last well over six months. But celery, lettuce, tomatoes, fruits, or vegetables don’t last more than a few days. Tosca: I have a library of over 3,000 recipes that are Eat Clean recipes. There are soups and stews and bars and desserts that we can make that are clean and that will help extend our grocery bill and keep our fruits and vegetables a little longer. Dr. Mache: Studies now show that home cooked meals are healthier,
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and people who eat together as families not only have healthier families but they also have better-mannered kids. There are a whole lot of positive things about eating at home and family meals. Tosca: I agree. I have to say I started my transformation late in life. At 40 years of age, I was leaving my first husband and I was at my heaviest, I weighed 204 pounds. Dr. Mache: Wow! Tosca: I did not have it figured out; I am my own transformation story. I’ve been successful at maintaining an 80-pound weight loss for these 16 years since I started eating clean. I have tens of thousands of followers who will say the same. Now, since that time, in the last four years as I shared with you prior to the show, I’ve had tremendous difficulty and strife. I’m not saying that I’ve had any more hardships than anybody else, but what I know to be true is that life is not a dress rehearsal. It’s real. Things come up all the time, so having the tools to care for ourselves nutritionally, physically and emotionally help bring us to a place of strength, and these are the things I’ve practiced which are part of the Eat Clean lifestyle, and that’s what makes it possible for people to actually transform today.
At 40 years of age, I was leaving my first husband and at my heaviest, I weighed 204 pounds If someone says, “My goodness, I need to lose 30 pounds, I need to lose 10 pounds, I need to lose 100 pounds,” it’s possible. I know it’s possible because I’ve done it and it returns you to such a beautiful place in your life, a place of optimal health that I believe is our birthright. Dr. Mache: Absolutely. What’s a reasonable expectation of rate of weight loss for people? Everybody, when they decide to lose wants to lose 100 pounds immediately; one lady told me she wanted to lose 150 pounds of ugly fat so she got divorced from her husband. Tosca: [Laughs] A good one. Dr. Mache: But what’s a reasonable rate for a loss that people can feel good about? Tosca: I think a healthy rate of weight loss, if you’re carrying in excess of 20 pounds of weight, is be-
The Hot Years Featured Article
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tween 3 to 5 pounds in a week. If we weighed less and we only want to shed those last five founds, we have to work a little harder because they cling to the system and our metabolic rate needs to be switched, and the way we eat needs to be switched. Sometimes all we need to do is clean our bowels out really well. Dr. Mache: I’ve suggested to people that if they could just focus on losing one pound a week, they lose 50 pounds in a year and make it so reachable. Tosca: Well, I celebrate a pound in weight loss, I celebrate an inch in weight loss, if you can take your measurements particularly around the lower hips, waist, and buttocks and get that measurement down by an inch you’ve done a benefit to your heart. So, never think that even the smallest measure of success isn’t successful. It’s huge, it’s a huge step for your body and even five pounds of weight loss changes your metabolic rate, the consistency of your blood, how your brain works, the force and pressure on your heart and lungs; so you can make an absolutely huge difference. What I also know to be true is that you must rely on a community to help support you through these
kinds of changes, and I have single pages for all of the challenges that I initiate at the Tosca Reno website because I know how difficult it is to make a change and how much support is needed, and I am there to provide it and to provide answers to questions every day. Dr. Mache: One last thing I wanted to ask you. Can you share one or two things you could tell people for belly fat because that’s the thing that I hear about the most. Tosca: This is going to sound funny, but we know fat is a safe storage place for toxins, so my key tip is always this: eat clean. Because the cleaner the food, the less toxic mess that’s stored in the fat. How I like to start everyday to begin that process is with a glass (8 ounces) of warm water with 2 tablespoons of raw apple cider vinegar in it and a little shot of honey if you can’t take the taste because it really does help to first flush out the bowels, helps to hydrate, and helps to get rid of some of that toxic mess. Tosca Reno’s website is www.toscareno.com. Tosca is a New York Times bestselling author and founder of Eat-Clean Diet.
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10
Benefits of Estrogen
If taken in The Estrogen Window
Mache Seibel, MD
The more you understand your estrogen window, the more control you will gain over your menopause symptoms
1 2
Extended protection from heart attacks and heart failure
Reduced risk of Alzheimer’s disease and other forms of cognitive decline
3 4 5
Reduced risk of osteoporosis Beneficial cosmetic effects on the structure and resiliency of the skin
Relief of sexual problems such as vaginal dryness and painful intercourse
6 7 8
Relief from troubling and sometimes disabling hot flashes
Improved quality of sleep
Stabilized mood, particularly in women who have a known mental health diagnosis
9 10
Lowered risk of type 2 diabetes
Support for bladder tissue and lower risk of recurring urinary tract infections
Click Here to learn about your estrogen window.
The Hot Years Sexuality
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News You Can Use
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Dispelling the Myth about Estrogen and Breast Cancer
Dr. Mache Seibel interviewed Dr. James Simon at the 2016 ACOG Annual Meeting.
M
any people believe that hormone therapy increases the risk of breast cancer. It’s a deep-seated belief that isn’t true. In fact, estrogen may actually slow the growth of existing breast cancer while estrogen plus progesterone may increase the growth of breast cancer slightly. This is different from actually causing the breast cancer in the first place. How did we get it so wrong? Within any time period, about ten percent of women have breast cancer and don’t know it. It they receive a medication such as a hormone that could cause cancer cells to grow slightly more rapidly, more cases would be seen on mammogram earlier and the person might believe their cancer was caused
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Early use of estrogen or estrogen plus progesterone, by women in their 50s has an overall benefit for most women by estrogen. In fact, the cancer was already there and just diagnosed earlier. It matters at what age people begin taking estrogen. When a woman begins her estrogen or estrogen plus progesterone is critical. It is often called the “window of opportunity” or “the estro-
gen window.” It means that early use of estrogen or estrogen plus progesterone, by women in their 50s has an overall benefit for women’s health. However, if the hormones are begun late in their window, or after their window closes, there is greater likelihood of risk. The benefit of taking estrogen is greatest for prevention of heart disease and all causes of death. You can actually reduce all causes of death by starting to use estrogen or estrogen plus progesterone in the 50s Dr. James A. Simon is a Clinical Professor of Ob/Gyn at The George Washington School of Medicine. Find more at JamesASimonMD.com.
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Stretching Improve Menopause
Can Simple
Mache Seibel, MD
Symptoms? Mache Seibel, MD
To answer this question, a group of researchers asked 45 women to stretch for 10 minutes daily before bedtime for three weeks and measured their menopause symptoms. Their findings will surprise you.
F
inding treatments for the symptoms of menopause can lead you on a long and challenging journey. Estrogen is very effective, but some women either cannot or will not take it. If that sounds like you, what should you do? Studies have shown that exercise can be very helpful for midlife symptoms, but what kind, for how long, and for what symptoms? Do you have to run a marathon, participate in moderate to vigorous exercise, or participate in involved aerobic exercise training?
What if the answer were as simple as gently stretching for 10 minutes before bedtime? This study was reported in the August 2016 issue of the journal Menopause. It
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involved 45 Japanese working women who were sales or clerical staff at a life insurance company in Tokyo Japan.
They were divided into two groups: ages 40 -49 and 50 years or older. Members of each of these two groups were randomly divided into those who did the stretching and those who did not. The study measured the effect of stretching on hot flashes, sleep, mood, and joint pain and shoulder stiffness. The only intervention was a 10-minute stretching program done once daily at bedtime or no stretching at all. The stretching included gentle stretching of the shoulders, hips and torso similar to some gentle yoga poses. None of the women were taking estrogen. Over half the participants had depression. Before the study, most of the women were inactive and didn’t exercise. The women who did the stretching had less depression than those who did not stretch. Five of the twelve participants in the stretching group who had depression at baseline recovered to normal level depression scores after the three weeks of stretching. Hot flashes improved in the stretching group, but the amount of improvement was not quite statistically significantly better than the control group. This is a very important study. It shows that the most important thing to do is to get started. Take action. Even 10 minutes can potentially make a huge difference. As I’ve said in other places, “Time spent on you isn’t lost; it’s invested™!
The Hot Years Q&A
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Got Questions? Ask Dr. Mache!
Tune in for the monthly AskDrMache.com HouseCallÂŽ The Third Thursday of Every Month Bring your friends, ask your questions, get your answers. Go to AskDrMache.com for call in information and to submit your questions.
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Tips For Your Lips:
How to Keep Them Kissable If you want to make your lips more kissable, you’re in for a treat with these Tips for More Kissable Lips.
Dr. Janet Prystowsky is a board-certified dermatologist in Manhattan with over 25 years experience. She’s going to explain what you can be doing to improve the quality of your mouth, face, and lips.
Dr. Mache Seibel: How big of an issue are the mouth and the lips as a cosmetic issue to women? Dr. Janet Prystowsky: I think women are very concerned about how their mouth and lips look. Certainly, every time you look in the mirror, you’re looking at your lips. But oral hygiene also plays an important role. If you’ve got the prettiest lips in the world, but as soon as you open your mouth there are a lot of unattractive teeth that haven’t been brightened, or are crooked, it really detracts. You can’t ignore what’s in the mouth and just depend on the lips to be attractive.
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You can’t ignore what’s in the mouth and just depend on the lips to be attractive Dr. Mache: What is good oral hygiene, because many times, the mouth is a source of infection. Teeth can also be an indication of osteoporosis. Dr. J. Prystowsky: I’ll tell you what I do. I brush my teeth twice a day, and spend about five minutes each time. I use an electric toothbrush because it cleans better than a regular toothbrush. Afterwards, I always use one of those little picks with the little rubber tip and go in between all the teeth, because it’s amazing how even with a good brushing you skip areas of little bits of food and particles that make your gums get bad and bleed. Dr. Mache: Those little rubber coneshaped things that you put between the teeth and get the circulation going? Dr. J. Prystowsky: That cone. Rinse it off and go inside all around. Then, next you floss. Even with that, you’re not going to get everything out from between the teeth. I think if you floss
two or three times a week and you do a really good flossing that’s probably adequate as long as you’re doing the “pick thing” every day. Dr. Mache: Little bits of food get stuck and that’s what the bacteria eat. Dr. J. Prystowsky: That’s my regimen. I don’t generally think you need to use mouthwash, but there’s no problem if you like that. Dr. Mache: What can you tell women about the things they put on their lips? Dr. J. Prystowsky: Let’s start with what is the goal. You want soft, supple, plump, lips with some color. They need to look a little red. To do that, you’ll have to use moisturizing products; you might need a lip balm. If you overuse lip balm, you can get allergic to them and have problems. But a simple lip balm like Aquaphor or plain
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at the corners of the mouth as you get towards menopause and they start to turn down. That keeps your lips even across. All that will help improve the appearance of the lips so that when you put the lipstick on, you get a bigger surface area and they’ll look more poofy and plump and kissable. Dr. Mache: The Angelina Jolie look. She has a beautiful mouth.
Vaseline works very well if your lips are dry. You certainly have to protect them before you go outside in the really cold weather around Valentine’s Day, at least up in the Northeast where I am. For color, you’re going to need some lipstick with a little help from the ladies behind the counter to get the right color. You may need to use lip liner as well if your lips are thin. But you may want to volumize them instead of just painting lips on. For that you may want to go to your dermatologist or your plastic surgeon and speak to them about how to volumize your lips. There are a number of different fillers. Obviously, you need to be cautious not to overdo it or it won’t look good. There are also many products to increase the size of your little “pillows”
Dr. J. Prystowsky: Yeah. Not destroy the Cupid’s bow. As you get towards menopause, the upper lip starts to flatten and you lose this Cupid bow. You want that little bow maintained. Dr. Mache: What’s the procedure involve? Is it injections, or how does it happen? Dr. J. Prystowsky: Normally, they’re injections. The most commonly used product in the lips is hyaluronic acid and there are a number of companies that make different brands. Sometimes we inject going right up the philtrum (the little groove between the base of the nose and the upper lip) and that will help to lift up the little Cupid bow. A lot of times we’ll add a little bit around the edges so that you don’t have that frowny look, and sometimes we’ll actually go all along the lip line to just enhance and bring things out a bit. So, those are the main injection sites
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Dr. Mache: To make it lift. Dr. J. Prystowsky: Lift it up and it will look great. Now, if you’ve got lots of wrinkles also going across, then you may need to tighten that up a bit to look more attractive. Dr. Mache: How long does it last once you do it? Dr. J. Prystowsky: It depends on what’s injected. Hyaluronic acid products are FDA approved for using around the lips and last 3 to 6 months. There’s some off label use of other substances. For example, silicone is not approved to inject for enhancing beauty, but has been used for decades. If it’s done correctly and safely with someone who’s skilled, it is a permanent filler, and so you get clearly a more lasting result from it. Dr. Mache: We’ve learned from talking with you is that it’s important to start with some simple oral hygiene. Take care of your mouth and teeth to get the stains off, straighten your teeth if you choose, and of course keep your teeth and gums clean. The second thing is that there are a number of products to place on the lips that you can find at the beauty counter, ranging from lipstick to Vaseline and many things in between.
If you want to enhance things even further, there are cosmetic procedures that can be done to inject the Cupid’s bow, as you called it here, to cause it to lift up, or go underneath or to expand the width of your lips from below or above and this lasts for 3 to 6 months, and if necessary you can do like the shampoos - rinse and repeat. So if you have to do it again, you can. This can allow you to have fuller lips, fresher breath and face, and also of course it’s something on your face, so it can enhance self-esteem and turn some heads. The one you really want to turn, of course, is your own, so when you look in the mirror, you say, “I like the way you look.” Dr. J. Prystowsky: Right. Absolutely. Dr. Prystowsky is a Manhattan cosmetic dermatologist. You can find out more about her at www.janetprystowskymd.com
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Six Unexpected Reasons Why
You Should Strengthen Your Abs! Women Over 40 Listen Up
Suzanne Andrews
Would you like to have flat abs? Looks aren’t the only reason to work your belly. Here are six unexpected and even more important reasons to blast belly fat and strengthen your core. You may be surprised!
1
To play sports and other awesome activities.
A strong core keeps you flexible and ready to take on activities like putting the kids or grandkids in and out of the car, and to keep up with them! Tennis anyone? You need a strong core so you don’t hurt yourself when you swing the racket. The same goes for golf. What about activities that involve balance, which includes walking? A strong core gives you better balance.
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2
To tackle housework.
If you don’t have a magic genie to do the housework, you need a strong core to be able to make home repairs, carry stuff, mop, vacuum and to make the many household chores and activities easier.
3
To ward off a heart attack.
A weak core is usually accompanied by belly fat. You need a strong core because belly fat puts you at higher risk of having a heart attack. In a study of over 5,000 participants, the National Heart, Lung and Blood Institute found that the risk of heart failure was 34 percent higher for overweight individuals and 104 percent higher for people classified as “obese.”
4 5
To improve posture.
Poor posture makes you look older and tireder. Strengthening your abs will improve your posture and literally slash years off your looks.
To develop a healthy back.
Back pains are often caused by weak abs. Since most back pain can be successfully treated with
therapeutic exercises, when back pain strikes, rehab therapists, including myself, recommend a string of core-strengthening exercises. A study by researchers at Duke University suggests that not exercising is an especially effective way to put on belly fat. The study, published in the Journal of Applied Physiology, found that just eight
Strengthening your abs will improve your posture and literally slash years off your looks months of inactivity increased visceral fat -- the potentially dangerous layer of belly fat -- by about 9 percent. On the bright side, people who exercised vigorously for eight months actually reduced their visceral fat by about 8 percent. You can get an amazingly strong core with chair exercises or standing exercises instead of engaging in floor crunches that can hurt your neck.
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To enjoy good sex.
A strong core is your powerhouse and will help you enjoy better sex with aging! Many people tell me that they don’t like doing abdominal exercises because they don’t want to tug at their neck or get down on the floor. Here’s a vertical ab toner move you can do standing up.
A strong core is your powerhouse and will help you enjoy better sex with aging
Now start training and live your life the way it was intended – a functional life filled with energy, abundant health and a toned belly! Suzanne Andrews founded Functional Fitness in 2008, the most popular fitness series for boomers and seniors broadcasting on over 159 Public Television stations throughout the US and Canada. Read Suzanne’s inspiring comeback story of how she survived a near fatal accident, From Deaths Door to Producing a National Fitness Series. Feel free to send Suzanne a message here.
Beginners use 0 -2 lb weights. Intermediate use 3-5 lb weights. Advanced use 6-8 lb weights. Stand with good posture holding your weights. Feet in line with your hips and chin parallel with the floor, shoulders slightly back. Now bring you knee up to meet your opposite hand. Do three sets of 12 on one side and repeat on the other side. Want more of a challenge? Round your back as you lift your knee up. (Rounding your back is not recommended if you have osteoporosis which is thinning bones).
Get Suzanne Andrews Get Stronger Bones DVD that includes her osteoporosis-walking workout at www.amazon.com/Suzanne-Andrews-Stronger-Workouts-Osteoporosis/dp/B01BM2X6GY
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Body Fat The Good, The Bad or
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The Ugly
There’s a lot of talk about belly fat. And it’s not just about looks. To find out what it is and what it does, read on… Caroline Apovian, MD
B
ody fat is what doctors call visceral adipose tissue. It’s fat that accumulates in the belly around and behind abdominal organs such as the bowel, pancreas, liver, and kidneys. The volume of visceral body fat can be estimated by measuring the waist circumference or WC. Here’s how to do that accurately. First, locate your lowest rib. It’s the bottom of your ribcage on the side of your body. Next locate the top of your hip bone (iliac crest). It should be a few inches below the bottom of your ribcage. Then place a measured tape around the smallest diameter between those two points. In women, if your WC is 35 inches or greater, you have
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too much visceral body fat; in men this number corresponds to 40 inches. As you can tell, the WC will also measure subcutaneous abdominal fat tissue (the fat just below the skin, which is “outside” the belly and organs) as well, but this is still a good estimate. The WC correlates positively with your risk of getting type 2 diabetes (T2DM), and cardiovascular disease (CVD).
The reasons why WC and therefore visceral body fat accumulation has a relationship with type 2 diabetes and cardiovascular disease relate to the differences between visceral and subcutaneous body fat. Visceral body fat is more “inflamed” than subcutaneous fat. Fat cells in visceral fat secrete special hormones called adipocytokines that cause inflammation in the fat tissue and in other organs. They aren’t the common hormone names you typically hear
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about. Here are the names of some of the most common adipocytokines: • C-Reactive Protein • Interleukin-6 or IL-6 • Tumor Necrosis Factor or TNF alpha Studies show that the visceral body fat carries greater risk of CVD and T2DM than subcutaneous body fat. That’s why those who have similar amounts of body fat but carry it mainly in the abdomen have greater risk of disease than those who carry it in the hips and thighs. Women are protected from CVD as compared to men as long as they are pre-menopausal. As women enter menopause, risk of CVD approaches
that of men. Why? Because women secrete estrogen, which favors the distribution of body fat towards hips and thighs. As women lose estrogen, their body fat is redistributed to the abdominal area. Studies have shown that hormone replacement therapy or HRT does reduce the redistribution of body fat in peri and postmenopausal women. So visceral body fat is bad fat, while subcutaneous body fat can be protective against CVD and T2DM and at least doesn’t seem to worsen blood sugar or triglycerides. What can you do in perimenopause to prevent redistribution of body fat? Studies have shown that exercise and
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Belly fat cells secrete hormones that can travel to the blood vessels, liver and heart and cause inflammation resistance exercise coupled with high protein diets can reduce redistribution of body fat. HRT, particularly if you are able to take it for several years during the perimenopausal period, can also prevent redistribution of body fat to the visceral area. The Body Mass Index or BMI (kg/m2) is a measure of body fat percentage in the body but it is not perfect and does not adequately estimate body fat in elite athletes. If your BMI is over 25 you are considered overweight. If it is over 30 you are considered obese. It also matters how much of your body fat is in your abdominal area. Therefore, if your BMI is over 30 and your WC is over 35 inches, you have an even higher risk of developing T2DM and CVD. We have sampled fat tissue of different patients and have found that those who have metabolic disease have inflamed fat tissue and those who do not have
metabolic disease (metabolic syndrome, T2DM, CVD) do not have inflamed tissue. Figure 1 and 2 show fat tissue histology in two patients with the same BMI. However, in one patient there are numerous stained cells surrounding dead fat tissue and in the other there are none of these cells. This is one of the differences between the two types of fat tissue. These visceral fat cells secrete hormones that then travel to the blood vessels, liver and heart and cause inflammation there as well. Inflammation in blood vessels eventually causes plaque formation that can clog the vessels and lead to CVD. As visceral fat accumulates, it can enter the liver, pancreas, and even muscle tissue. Summary: There are two kinds of fat tissue - visceral and subcutaneous. Visceral fat tissue is highly linked to metabolic diseases such as T2DM and CVD. Prevention or reduction of visceral body fat programs include high protein diets, resistance and aerobic exercise, and sometimes hormone replacement therapy. And that’s the good, the bad and the ugly about fat! Dr. Caroline Apovian is a regular contributor to The Hot Years, My Menopause Magazine. She is Director, Center for Nutrition and Weight Management at Boston Medical Center and author of the New York Times bestselling book, The Age Defying Diet. Find out more at DrApovian.com.
Dr. Trevor Cates
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Questions to Ask About Your Skincare Is your skincare both effective and healthy? These 3 questions will let you know.
We all want to look and feel our best, at every age. With passing time, we tend to spend more time and money on skincare products to help us maintain our youthful appearance. The problem is that these products are often not effective. In addition, the may contain toxic ingredients that are harmful to our skin and overall health. In my experience practicing as a naturopathic physician and owner of a natural skincare line, I’ve found there are 3 questions you should ask about your skincare to ensure in is both effective and healthy.
Dr. Trevor Cates
1
Is it free of toxic ingredients?
The European Union has banned over 1000 ingredients in personal care products while the FDA has banned only 11. Many popular skincare products contain known endocrine disrupting chemicals (EDCs). EDCs are a class of chemicals that, in studies, are associated with conditions such as thyroid problems, infertility, early puberty, obe-
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sity, diabetes, and certain types of cancer (such as prostate and breast). At a time when our hormones are changing, why would we want to disrupt them even further with exposure to EDCs in skincare products? One of the chemicals in fragrance that is of particular concern is diethyl phthalate (DEP). It is used to make smells last longer, but they’re a known EDC. And, that’s just one ingredient. There are many others of concern such as formaldehyde-releasers, oxybenzone, and parabens. What you put on your body can penetrate your skin and end up in your blood stream. So take a closer look at your ingredient labels. Use resources such as the Campaign for Safe Cosmetics website or Skin Safe Products for more information on ingredients to avoid.
2
Does it contain key nutrients in their active, pure form?
There is more research now on natural ingredients than ever before. We know that ingredients such as white and green tea extracts, CoQ10, tocopherol and vitamin C are potent antioxidants providing protective and skin-nourishing benefits for glowing more youthful looking skin. Many skincare companies are now using some natural ingredients, but if you look closely at
the label (if you can even find it!), you’ll probably find many other synthetic ingredients in there. In addition, it’s important to choose products using clean and pure ingredients in their most potent forms found in nature. Most skincare products contain such a small amount of the natural ingredients that they’re not actually going to be effective. Manufacturers may use a very weak version of isolated nutrients. This will prevent the products from doing what research shows natural ingredients can do. Unfortunately, this is one of the reasons we often hear, “natural skincare products don’t work.”
3
Is it pH formulated towards mild acidity?
Your skin’s exterior has a natural pH level of about 4 to 4.5, which helps your skin stay hydrated and healthy. When you use cleansers and other skincare products on your face or other areas of your skin (including your vulva) that have a higher pH (generally over 5.5), then it can make your skin more prone to dryness, infections, outbreaks, and premature aging. If a cleanser suds or foams, it is likely too alkaline (pH too high), and even water’s pH of 7 can throw off the pH balance of your skin.
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Keeping your skin in its ideal pH zone by using mildly acidic skincare products helps protect your skin’s natural microbiome. The skin’s microbiome is the delicate balance of microorganisms that live on the skin and protect it from inflammation, acne, and premature aging. So, I encourage you to check your skincare pH to ensure it’s below 5.5 so your skin microbiome can flourish and help you achieve clear, glowing skin at any age. Not all natural skincare products are made this way, so it important to look closely and ask questions. I was determined to create skincare products that embrace all three of these, and that is
When our skin is clear and glowing, confidence follows, and that’s when the real natural beauty shines through what led me to start my own company and The Spa Dr. skincare line. When our skin is clear and glowing, confidence follows, and that’s when the real natural beauty shines through.
Dr. Trevor Cates is known, as “The Spa Dr.,” and was the first woman licensed as a naturopathic doctor in the state of California. She has been featured on the Doctors, Extra, First for Women, Mind Body Green and is host of THE SPA DR. iTunes Podcast. Her new book Clean Skin from Within will be released in early 2017. Visit www.TheSpaDr.com to learn more.
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The Hot Years Recipe
Orange
Spinach Wild Salmon Dr. Catherine Katz
Wild salmon with spinach is not only another one of those nutritionally winning combination but a culinary delight as well! The simple marinade of fresh orange juice, extra virgin olive oil and white balsamic vinegar just brings it all together. It’s also just so beautiful and inviting! *The salmon filet should be about 1 inch thick and 1½ inch wide. Serves: 4
Ingredients • Marinade: • Juice of 2 medium oranges (about ½ cup) • ¼ cup extra virgin olive oil • 2 Tbsp white balsamic vinegar • ¾ tsp coarse salt • fresh ground pepper to taste • The dish: • 4 wild salmon filets (about 1½ lb) • 1/8 tsp salt • 10-12 oz fresh baby spinach • 10 sundried tomatoes (no oil) • 2 oranges, sliced in half moons
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Instructions
1 2 3
Preheat oven 350 F. Place all the marinade ingredients in a small bowl, stir well and put aside.
Place spinach at the bottom of a baking dish (it will seem like a lot, but don’t worry, it will diminish in size considerably when baked!).
4
Lightly salt the salmon filet with no more than 1/8 tsp, and place on top of spinach.
5
Top each filet with a slice of orange and place the sundried tomatoes all around (see photo at the bottom of the page).
6
Drizzle the marinade over everything and place in preheated oven for 25 minutes.
7
When ready, place the remaining sliced oranges all around and serve.
Dr. Catherine Katz is a French-bornand raised foodie, and lover of luscious cuisine. She is also a scientist with a PhD in neuroscience from Princeton University. Married to Dr. David Katz, together they have perfected the recipe for not only a beautiful family, but also for wonderful, healthy cuisine. Visit Cuisinicity.com to learn more and get delicious recipes!
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Find out how much your menopause symptoms impact your health, your happiness and your life.
Visit MenopauseQuiz.com to take the free Menopause Quiz. It only takes a minute, then watch your email for your results and some suggestions on next steps to support you. Your menopause mentor, Mache Seibel, MD
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You may be disappointed if you fail, but you are doomed if you don’t try.
Beverly Sills
CLICK HERE to hear the Song of The Month. I wrote Red Hot Mama to celebrate menopause. Visit www.DoctorSeibel.com/store/cds for additional songs and CDs. Every effort has been made to ensure that the information contained in this magazine is complete and accurate. However, neither the publisher nor the author(s) is engaged in rendering professional advice or services to the individual reader. The ideas, procedures, and suggestions contained in this magazine are educational and not intended as a substitute for consulting with your physician. All matters regarding health require medical supervision. Neither the authors nor the publisher shall be liable or responsible for any loss, injury, or damage allegedly arising from any information or suggestion in this magazine. The opinions expressed in this magazine represent personal views of the author(s) and are not a substitute for medical care. All content in this magazine is Copyright Š HealthRock, LLC
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