women’s health

Sunscreen use now implicated in widespread vitamin D deficiency

Results from a clinical review find nearly 1 billion people worldwide may have deficient or insufficient levels of vitamin D due to chronic disease and inadequate sun exposure related to sunscreen use.

Results from a clinical review published in The Journal of the American Osteopathic Association find nearly 1 billion people worldwide may have deficient or insufficient levels of vitamin D due to chronic disease and inadequate sun exposure related to sunscreen use.

The study also found that 95 percent of African American adults may have vitamin D deficiency or insufficiency. Vitamin D variations among races are attributed to differences in skin pigmentation.

“People are spending less time outside and, when they do go out, they’re typically wearing sunscreen, which essentially nullifies the body’s ability to produce vitamin D,” said Kim Pfotenhauer, DO, assistant professor at Touro University and a researcher on this study. “While we want people to protect themselves against skin cancer, there are healthy, moderate levels of unprotected sun exposure that can be very helpful in boosting vitamin D.”

Dr. Pfotenhauer also said chronic diseases like Type 2 Diabetes and those related to malabsorption, including kidney disease, Crohn’s and celiac disease greatly inhibit the body’s ability to metabolize vitamin D from food sources.

Considered a hormone rather than a vitamin, vitamin D is produced when skin is exposed to sunlight. Vitamin D receptors are found in virtually every cell in the human body. As a result, it plays a wide role in the body’s functions, including cell growth modulation, neuromuscular and immune function and inflammation reduction.

Symptoms for insufficient or deficient vitamin D include muscle weakness and bone fractures. People exhibiting these symptoms or who have chronic diseases known to decrease vitamin D, should have their levels checked and, if found to be low, discuss treatment options. However, universal screening is likely neither necessary nor prudent absent significant symptoms or chronic disease.

Increasing and maintaining healthy vitamin D levels can be as easy as spending 5-30 minutes in midday sun twice per week. The appropriate time depends on a person’s geographic location and skin pigmentation — lighter skin synthesizes more vitamin D than darker skin. It is important to forgo sunscreen during these sessions because SPF 15 or greater decreases vitamin D3 production by 99 percent.

“You don’t need to go sunbathing at the beach to get the benefits,” said Dr. Pfotenhauer. “A simple walk with arms and legs exposed is enough for most people.”

Food sources such as milk, breakfast cereals, and Portobello mushrooms are also fortified with vitamin D. Dr. Pfotenhauer said supplements are a good option, as they are effective and pose few risks, provided they are taken as directed and a physician is consulted beforehand.

Research is ongoing to determine whether vitamin D deficiency has a role in multiple sclerosis, autoimmune disorders, infections, respiratory disease, cardiometabolic disease, cancer, and fracture risk.

“Science has been trying to find a one-to-one correspondence between vitamin D levels and specific diseases,” said Dr. Pfotenhauer. “Given vitamin D’s ubiquitous role in the body, I believe sufficient vitamin D is more about overall health. Our job as osteopathic physicians is to recognize those patients that need to be tested and treat them accordingly.”

Currently, insufficiency is defined as between 21 and 30 ng/ml and deficiency is considered below 20ng/ml by the Endocrine Society.


Story Source: Materials provided by American Osteopathic Association. Note: Content may be edited for style and length.

Read this article on Science Daily: American Osteopathic Association. “Widespread vitamin D deficiency likely due to sunscreen use, increase of chronic diseases, review finds.” ScienceDaily. ScienceDaily, 1 May 2017. www.sciencedaily.com/releases/2017/05/170501102258.htm.

Inadequate sleep may increase risk of bone loss in women

Insufficient sleep, a common problem that has been linked to chronic disease risk, might also be an unrecognized risk factor for bone loss. Results of a new study will be presented Saturday at the Endocrine Society’s 99th annual meeting in Orlando, Fla.

The study investigators found that healthy men had reduced levels of a marker of bone formation in their blood after three weeks of cumulative sleep restriction and circadian disruption, similar to that seen in jet lag or shift work, while a biological marker of bone resorption, or breakdown, was unchanged.

“This altered bone balance creates a potential bone loss window that could lead to osteoporosis and bone fractures,” lead investigator Christine Swanson, M.D., an assistant professor at the University of Colorado in Aurora, Colo., said. Swanson completed the research while she was a fellow at Oregon Health & Science University in Portland, Ore., with Drs. Eric S. Orwoll and Steven A. Shea.

“If chronic sleep disturbance is identified as a new risk factor for osteoporosis, it could help explain why there is no clear cause for osteoporosis in the approximately 50 percent of the estimated 54 million Americans with low bone mass or osteoporosis,” Swanson said.

Inadequate sleep is also prevalent, affecting more than 25 percent of the U.S. population occasionally and 10 percent frequently, the Centers for Disease Control and Prevention report.

The 10 men in this study were part of a larger study that some of Swanson’s co-authors conducted in 2012 at Brigham and Women’s Hospital in Boston, Mass. That study evaluated health consequences of sleep restriction combined with circadian disruption. Swanson defined circadian disruption as “a mismatch between your internal body clock and the environment caused by living on a shorter or longer day than 24 hours.”

Study subjects stayed in a lab, where for three weeks they went to sleep each day four hours later than the prior day, resulting in a 28-hour “day.” Swanson likened this change to “flying four time zones west every day for three weeks.” The men were allowed to sleep only 5.6 hours per 24-hour period, since short sleep is also common for night and shift workers. While awake, the men ate the same amounts of calories and nutrients throughout the study. Blood samples were obtained at baseline and again after the three weeks of sleep manipulation for measurement of bone biomarkers. Six of the men were ages 20 to 27, and the other four were ages 55 to 65. Limited funding prevented the examination of serum from the women in this study initially, but the group plans to investigate sex differences in the sleep-bone relationship in subsequent studies.

After three weeks, all men had significantly reduced levels of a bone formation marker called P1NP compared with baseline, the researchers reported. This decline was greater for the younger men than the older men: a 27 percent versus 18 percent decrease. She added that levels of the bone resorption marker CTX remained unchanged, an indication that old bone could break down without new bone being formed.

“These data suggest that sleep disruption may be most detrimental to bone metabolism earlier in life, when bone growth and accrual are crucial for long-term skeletal health,” she said. “Further studies are needed to confirm these findings and to explore if there are differences in women.”


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Materials provided by The Endocrine Society. Note: Content may be edited for style and length.


Read this article on Science Daily: The Endocrine Society. “Prolonged sleep disturbance can lead to lower bone formation.” ScienceDaily. ScienceDaily, 2 April 2017. <www.sciencedaily.com/releases/2017/04/170402111317.htm>.

Most Women of Child Bearing Age Lack Knowledge of Healthy Diet Says New Study

Dr. Lela Emad of the Women’s OB/GYN Medical Group discusses the latest findings on diet and nutrition among women and offers some guidelines for women planning for pregnancy.

A new study by the University of Pittsburgh Schools of the Health Sciences uncovers a national trend toward a less than optimal diet among women prior to pregnancy. “This information is particularly concerning for women who intend to conceive,” says Dr. Lela Emad of the Women’s OB/GYN Medical Group of Santa Rosa. “It’s imperative that prior to pregnancy, women follow a higher standard of nutrition for several reasons; to ensure healthy growth of the fetus, to reduce risks associated with premature birth, and to avoid the possibility of preeclampsia and maternal obesity – both of which carry added risks to the mother and baby.”

The study, published in the Journal of the Academy of Nutrition and Dietetics, assessed more than 7,500 women participants using the Healthy Eating Index-2010, measuring quality of diet including the intake for key food groups, while also measuring the consumption of less desirable aspects of a typical American diet such as refined grains, salt and calories from solid fats and sugars from food as well as from alcohol consumption.

Ultimately, more than a third of the calories the women in the study consumed came from ‘empty calories’ from such things as;

  • sugar-sweetened beverages,
  • pasta dishes
  • grain desserts
  • Soda
  • beer, wine and spirits

“This list consists of just about everything we would recommend a woman who was in a preconception phase to avoid,” Dr. Emad points out. “A healthy diet goes a long way toward ensuring a healthy pregnancy, and planning ahead for pregnancy by participating in a Preconception Healthcare Plan is one of the best things a woman can do both for her baby and for herself.”

What is Preconception Healthcare

Preconception healthcare describes medical care provided to a woman that is designed to increase the chances of having a positive pregnancy experience and a healthy baby. Preconception healthcare is uniquely designed for every individual, customized for personal needs and circumstances. It typically offers an introduction to guidelines for a healthy diet as part of the overall education and planning process.

“We encourage parents – that is, both parents – to begin making healthy lifestyle changes up to one full year prior to trying to get pregnant,” explains Dr. Emad. “This process improves a woman’s chances of becoming pregnant and prepares her body so it can provide the best environment for her infant.” During a preconception care visit, the OB/GYN healthcare provider will focus on lifestyle, medical and family history, previous pregnancies and currently prescribed medications. In addition to diet and exercise, topics may include alcohol, tobacco, and caffeine use; recreational drug use, birth control, family histories, genetics as well as health issues and other concerns (diabetes, high blood pressure, depression, obesity, etc.)

Healthy Diet and Supplements

“We also encourage our patients and their families to adopt a nutrient rich and calorie conscious diet prior to and during pregnancy. This is the best way to prevent excessive weight gain and cut the potential risk of obstetric complications,” says Dr. Emad. “Planning ahead and taking steps to ensure optimal pre-pregnancy health is a great way to create a healthy family.”

Learning how to make smart food choices as well as being mindful about food preparation is important, as is knowing which foods to avoid or limit during pregnancy. Foods that contain sources of folic acid (vitamin B9) are important nutritional elements to incorporate into both the preconception and pregnancy diet. Folic acid helps to prevent some birth defects – particularly those affecting the brain and spinal cord. Folic acid is best taken before pregnancy and in the very early stages of pregnancy.

Although the bulk of nutrients should ideally come from eating fresh healthy foods, it is generally recommended that women start taking a prenatal vitamin supplement before pregnancy. Prenatal vitamin supplements are specifically formulated to contain all the recommended daily vitamins and minerals needed before and during pregnancy.

About Women’s OBGYN Medical Group

The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. To learn more about these fine physicians and the many services provided by the Women’s OB/GYN Medical Group visit the website. Call for an appointment at (707) 579-1102.

Good news for mature women: weight loss is possible after menopause

Talk to a woman in menopause and you’re likely to hear complaints about hot flashes and an inability to lose weight, especially belly fat. A new study shows how regular exercise can help reduce weight and control bothersome symptoms such as hot flashes, even in women who previously led sedentary lifestyles. The study outcomes are being published online today in Menopause, the journal of The North American Menopause Society (NAMS).

Decreased estrogen levels during the menopause transition often create an array of physical and mental health issues that detract from a woman’s overall quality of life. The article “Improvements in health-related qualify of life, cardio-metabolic health, and fitness in postmenopausal women after a supervised, multicomponent, adapted exercise program in a suited health promotion intervention: a multigroup study” reports on 234 Spanish postmenopausal women aged 45 to 64 years who had at least 12 months of sedentary behavior and engaged in a supervised 20-week exercise program for the study. After the intervention, the participants experienced positive changes in short- and long-term physical and mental health, including significant improvements in their cardiovascular fitness and flexibility. In addition, they achieved modest but significant reductions in their weight and body mass index, and their hot flashes were effectively managed. This is especially good news for women who are reluctant to use hormones to manage their menopause symptoms and are looking for safe but effective nonpharmacologic options without adverse effects.

“Growing evidence indicates that an active lifestyle with regular exercise enhances health, quality of life, and fitness in postmenopausal women,” says Dr. JoAnn Pinkerton, NAMS executive director. “Documented results have shown fewer hot flashes and improved mood and that, overall, women are feeling better while their health risks decrease.


Story Source:Materials provided by The North American Menopause Society (NAMS). Note: Content may be edited for style and length.


Read this article on ScienceDaily:

The North American Menopause Society (NAMS). “Weight loss actually possible after menopause.” ScienceDaily. ScienceDaily, 15 February 2017. <www.sciencedaily.com/releases/2017/02/170215084052.htm>.

Can eating soy products affect breast health?

Georgetown Lombardi Comprehensive Cancer Center researchers have used animal models to reveal new information about the impact — positive and negative — that soy consumption could have on a common breast cancer treatment.

The scientists have uncovered the biological pathways in rats by which longtime soy consumption improves effectiveness of tamoxifen and reduces breast cancer recurrence. But they also show why eating or drinking soy-based foods for the first time while being treated with tamoxifen can, conversely, reduce effectiveness of the drug, and promote recurrence.

The study, published in Clinical Cancer Research, uncovers the molecular biology behind how soy consumption, especially its most active isoflavone, genistein, affects tamoxifen — both positively and negatively.

It also mirrors what has been observed in breast cancer patients, says the study’s senior investigator Leena Hilakivi-Clarke, PhD, professor of oncology at Georgetown Lombardi.

“There has long been a paradox concerning genistein, which has the similar structure as estrogen and activates both human estrogen receptors to a degree. Estrogen drives most breast cancer growth, yet high soy intake among women in Asian countries has been linked to a breast cancer rate that is five times lower than Western women, who eat much less soy,” she says. “So why is soy, which mimics estrogen, protective in Asian women?”

More than 70 percent of the 1.67 million women diagnosed with breast cancer worldwide in 2012 was estrogen-receptor positive, and tamoxifen and other endocrine therapies meant to reduce the ability of estrogen to promote cancer growth, are the most common drugs used for these cancers. Although endocrine therapies can be highly effective in preventing or treating breast cancer, about half of patients who use them exhibit resistance and/or have cancer recurrence.

Employing a more advanced rat model of breast cancer and tamoxifen use than has been used in past studies, the researchers found that the timing of genistein intake is the central issue.

Longtime sustained use of genistein before development of breast cancer improves overall immunity against cancer, thus protecting against cancer development and recurrence, says the study’s lead researcher, Xiyuan Zhang, PhD.

“It also inhibits a mechanism called autophagy that would allow cancer cells to survive, which explains why it helps tamoxifen work,” says Zhang, a member of Hilakivi-Clarke’s laboratory when this study was conducted. She is currently a postdoctoral researcher at the National Institutes of Health.

Previous studies in women show no evidence of adverse effects of soy intake on breast cancer outcome, the researchers say, adding that research has also shown that Asian and Caucasian women who consumed as little as 1/3rd cup of soymilk daily (10 mg. of isoflavones) had the lowest risk of breast cancer recurrence.

The animal studies suggest it is a different story when soy consumption begins after breast cancer develops.

Starting consuming genistein in a diet after breast cancer develops in the animals did not trigger anti-tumor immune response to eliminate cancer cells, Zhang says. “We do not know yet why this made the animals resistant to the beneficial effects of tamoxifen and increased risk of cancer recurrence,” she continued.

Animals consuming genistein as adults on had a 7 percent chance of breast cancer recurrence after tamoxifen treatment, compared with a 33 percent recurrence with rats exposed to genistein only after breast cancer developed.

“We have solved the puzzle of genistein and breast cancer in our rat model, which perfectly explains the paradox seen in earlier animal studies and patients,” says Hilakivi-Clarke. “While many oncologists advise their patients not to take isoflavone supplements or consume soy foods, our findings suggest a more nuanced message — if these results hold true for women. Our results suggest that breast cancer patients should continue consuming soy foods after diagnosis, but not to start them if they have not consumed genistein previously.”


Story Source:

Materials provided by Georgetown University Medical Center. Note: Content may be edited for style and length.


Read this article on ScienceDaily: Georgetown University Medical Center. “Understanding when eating soy might help or harm in breast cancer treatment.” ScienceDaily. ScienceDaily, 1 February 2017. www.sciencedaily.com/releases/2017/02/170201092711.htm.

Study concludes: Grilled meat deadly for breast cancer survivors

Findings published in JNCI: Journal of the National Cancer Institute indicate that higher consumption of grilled, barbecued, and smoked meat may increase the mortality risk among breast cancer survivors. In the study, entitled “Grilled, Barbecued, and Smoked Meat Intake and Survival Following Breast Cancer,” Humberto Parada, Jr., MPH, and colleagues evaluated the link between grilled/barbecued and smoked meats and the survival time after breast cancer.

High-temperature cooked meat intake is a highly prevalent source of polycyclic aromatic hydrocarbons and other carcinogenic chemicals and has been associated with breast cancer incidence, but this study assessed whether intake is related to survival after breast cancer.

In a study population of 1508 Long Island women with breast cancer, subjects were interviewed and asked about their consumption of four types of grilled, barbecued, and smoked meat. The women were asked about their intake in each decade of life and were asked to specify the seasons in which the foods were most frequently consumed. At the five-year follow-up, participants responded to the same questions, which asked about the time period since the original questionnaire.

Findings include:

  • Among the 1508 case women, 597 deaths were identified, 237 (39.7%) of which were related to breast cancer, after a median duration of follow-up of 17.6 years.
  • Compared with low intake, high intake of grilled/barbecued and smoked meat prior to diagnosis was associated with a 23% increased hazard of all-cause mortality.
  • High vs low intake of smoked beef/lamb/pork intake was associated with a 17% increased hazard of all-cause and a 23% increased hazard of breast cancer-specific mortality.
  • Lifetime grilled/barbecued and smoked meat intake and prediagnosis annual intake of grilled/barbecued beef/lamb/pork and poultry/fish were not associated with mortality.
  • Compared with women with low prediagnosis and low postdiagnosis intake of grilled/barbecued and smoked meat, continued high intake was associated with a 31% increased hazard of all-cause mortality.
  • The increase in risk of death from any cause was similar in magnitude among women who reported high prediagnosis and low postdiagnosis intake of grilled/barbecued and smoked meat.

The study’s findings support the hypothesis that high consumption of grilled, barbecued, and smoked meat may increase mortality after breast cancer.


Story Source:

Materials provided by Oxford University Press USA. Note: Content may be edited for style and length.


Journal Reference:

  1. Humberto Parada, Susan E. Steck, Patrick T. Bradshaw, Lawrence S. Engel, Kathleen Conway, Susan L. Teitelbaum, Alfred I. Neugut, Regina M. Santella, Marilie D. Gammon. Grilled, Barbecued, and Smoked Meat Intake and Survival Following Breast Cancer. Journal of the National Cancer Institute, 2017; 109 (6): djw299 DOI: 10.1093/jnci/djw299

Read this article on ScienceDaily: https://www.sciencedaily.com/releases/2017/01/170105212820.htm

There’s been a lot of talk about baby power and ovarian cancer

Does Baby Powder cause cancer in women? Research into link mixed

baby-powderThousands of women with ovarian cancer have filed suit against the consumer-products giant Johnson & Johnson, claiming that the company’s Baby Powder caused their disease and pointing to a long trail of studies linking talc to the cancer. The research dates to 1971, when scientists in Wales discovered particles of talc embedded in ovarian and cervical tumors. Since then, numerous studies have linked genital talc use to ovarian cancer, including a report earlier this month that among African-American women, genital use of powder is linked with a 44 percent increased risk for invasive epithelial ovarian cancer.

Although Johnson & Johnson’s talc supplier added warning labels in 2006, the company did not add similar warnings to its products, according to litigation documents. Baby powder does carry a warning to keep it out of the reach of children, and many pediatricians discourage its use on babies, who can become ill or die after breathing in the particles. Inhalation studies in female rats demonstrated carcinogenicity, according to the National Toxicology Program. Condom and surgical glove makers have stopped dusting their products with talc.

Read the full story here …