Have you ever noticed a particularly fit person and thought to yourself, “How do they do that?” Or maybe you’re considering spending thirty bucks on the latest fitness video. But the key word is “considering,” since you haven’t actually pulled out the charge card.

Why the sudden urge to exercise? Well, it might be because bathing suit season is around the corner, the little muffin top is driving you crazy, or you just don’t want to be a couch potato any more. As we get older, it’s even more important that we maintain an active and healthy lifestyle.  Finding the time and motivation, though, can be a challenge for many of us.

New studies recommend at least 60 minutes of moderate physical activity every day. Yikes. That seems like incredible amount of dedication and commitment, especially if you’ve been using your treadmill as a coat rack for the past few years.

So how does a real woman fit exercise into her daily routine? It’s going to take a little effort, but here a few ways to start:

1. Be honest and set reasonable goals. What exactly do you want to accomplish? Are you just trying to be more active or lose a few pounds? Don’t put too much pressure on yourself to run a marathon if you haven’t been on a running track since college. Baby steps.
2. Find a type of exercise you really enjoy. Just because your best friend loves her step class doesn’t mean you will, too. Maybe you’re more of walker and that’s perfectly okay.
3. Enlist the help of a personal trainer, friend or neighbor. Partner with someone who’ll expect you to show up at a certain time to work out. Having a sense of accountability is sometimes a great motivator.
4. Keep track of, and schedule, your exercise time. If it’s not set in stone, you’re going to find a way to get out of it. And you’ll probably waste more time making excuses than actually working out in the first place.
5. Use the reward system. Make sure to map out weekly or monthly milestones and celebrate the small victories. Lost five pounds or stuck to your plan for a month? Treat yourself to a manicure. Or a new pair of shoes.
6. Talk to your doctor. Before you begin any type of exercise plan or make dramatic changes to your diet, set an appointment with a professional. You may know your body, but you need to be aware of any potential health concerns, as well.

Every day starts with a fresh set of twenty four hours. So do yourself a favor and invest some of that time in you. That first step might be a walk after dinner, a trip to the gym or a yoga class. Just get moving.

Holly Osterman is the founder of Menopause ChitChat and blogs regularly about the journey through menopause. She also hosts a menopause forum, where women can share their stories, ask questions, and connect with other women.

Optimal nutrition for a healthy life
As a physician, much of my time is spent on the diagnosis and treatment of disease. While that’s very important, I believe good health is more than just the absence of disease — it’s living the healthiest life possible. That’s why I’m constantly encouraging my patients to adopt healthy habits that lead to a lifetime of wellness. Today, I’d like to discuss how optimal nutrition can be achieved by adopting a plant-based diet.

So you’re probably wondering, “What is considered a plant-based diet?” My definition of a plant-based diet is one that primarily focuses on the consumption of:
• vegetables and fruits (especially green, leafy vegetables and brightly colored berries),
• beans and legumes,
• olive oil, tree nuts and avocado,
• wild salmon, sardines, walnuts and freshly ground flaxseed,
• whole grains,
• plenty of water, and
• green tea.

For more recipes, click here.

I know what you’re thinking — “This is so different from what I’m used to eating!” And you’re right, it is. But by gradually introducing more plant-based foods to your diet and gradually eliminating meats, you won’t feel as deprived. Best of all, you’ll soon be experiencing the health benefits of a plant-based diet.

If you need science to back up the health benefits of a plant-based diet, consider this — a 2005 Stanford study that compared cholesterol levels of those on a plant-based, low-fat diet compared to those on a standard, low-fat diet, showed the plant-based group had significantly lower cholesterol levels.
What’s more, a plant-based diet can also help reduce the risk of cancer, obesity, diabetes, hypertension and even Alzheimer’s disease.

For more information, click here.

I recently attended a women’s health conference where I had the privilege of hearing Henda Salmeron speak. Henda is a courageous breast cancer survivor who fought to have legislation passed in Texas that makes it mandatory for doctors to tell women if they have dense breast tissue. This battle was personal for Henda, a woman with dense breast tissue, whose breast cancer was not visible on 2 annual mammograms and a breast ultrasound. Henda’s dense breasts hid the tumor. Her tumor was diagnosed when Henda insisted on additional evaluation of the lump she felt in her breast.

Henda’s cancer was later stage at diagnosis because her dense breast tissue masked the cancer. Dense breast tissue and lumps appear white on a mammogram so finding cancer in dense breasts can be like trying to find a polar bear in a snow storm. More than half of women age 50 and younger and one third of women older than 50 have dense breast tissue. Breasts with a higher percentage of tissue than fat are considered dense. After having years of mammograms, not one doctor told Henda she had dense tissue.

Thanks to Henda, women in Texas now must be informed by their doctor if they have dense breast tissue and the risk of not detecting abnormalities with mammogram screening. Doctors now explain that they may need other testing, such as ultrasound, breast MRI or molecular breast imaging to successfully rule out tumors.
Hopefully, by sharing Henda’s message, even more women will be able to make informed choices to help protect their future health.

I bet you didn’t know…

that dense breasts are a cancer risk factor? It’s true, women who have extremely dense breast tissue are at a 4 to 6x greater risk of developing breast cancer. For more information, click here.

Save the date for our next SMV & Twitter Chat
My next SMV, which will focus on perimenopause and menopause, is scheduled for Thursday, May 24, from 6:30 to 8 pm, at our office. To register, please call the office at 513.271.5111 or send an email to officeinfo@lisalarkinmd.com.

I’m also launching a monthly chat on Twitter about women’s health issues. The first one, about menopause, will be on May 16th from noon to 1pm EDT. I’ll be using the hashtag #LarkinChats. My Twitter handle is @LisaLarkinMD.

Patients taking the osteoporosis drug Boniva® (ibandronate) will be happy to learn that the U.S. Food and Drug Administration (FDA) has just approved the first generic, lower-cost alternative versions of the once-a-month tablets.

Three companies—Apotex Inc., Orchid Healthcare, and Mylan Pharmaceuticals Inc.—have gained FDA approval to manufacture the generic pills, which will be medically equivalent to the brand-name version and subject to the same quality standards.

Characterized by a thinning of the bones or loss of bone density over time, osteoporosis is the most common type of bone disease. According to the National Osteoporosis Foundation, more than 40 million Americans already have the disease or are at high risk due to low bone mass—and 80% of those affected are women.

Most common among post-menopausal women, osteoporosis increases the risk of hip, spine and wrist fractures. Medications like Boniva® help increase bone mass and reduce the chance of such fractures.

While often mistaken as an older person’s disease, osteoporosis can strike at any age. That’s why it’s important to take steps now to optimize your bone health and help prevent osteoporosis:

1. Get the calcium and vitamin D you need every day.
2. Do regular weight-bearing and muscle-strengthening exercises.
3. Don’t smoke and don’t drink too much alcohol.
4. Talk to your healthcare provider about your chance of getting osteoporosis, and ask when you should have a bone density test.
5. Take an osteoporosis medicine if your doctor says it’s right for you.

Information about the availability of generic ibandronate can be obtained from the manufacturers.

Most women can now go five years between cervical cancer screenings, according to recommendations released by the U.S. Preventive Services Task Force and the American Cancer Society earlier this month.

For the first time ever, the guidelines also recommend screening for the common sexually transmitted disease human papillomavirus (HPV) in conjunction with traditional Pap testing for precancerous cells. Co-testing is important, not only because the tests screen for different things, but also because HPV has been found to cause most cervical cancers. With the addition of the HPV test, women ages 30–65 can safely lengthen the screening cycle to every five years, as long as results are negative.

*HPV-vaccinated women should be screened at the same intervals as unvaccinated women in their age group.
^†Reflex HPV testing means an HPV test is only performed if a Pap smear result is abnormal.

Women ages 21 to 29 should be screened every three years with a Pap test only. Regular HPV testing in this age group is discouraged since many of these women have HPV infections that will soon go away on their own. That said, an HPV test is recommended as a follow-up when a Pap smear result is abnormal.

Since HPV infection in women ages 30 to 65 may indicate a persistent infection that could increase cancer risk, the guidelines recommend co-testing (Pap and HPV) every five years for this age group. (The guidelines do note, however, that screening with a Pap test only, every three years, is an acceptable alternative.)

Both sets of guidelines recommend that average-risk women younger than age 21 and older than 65 skip the screenings altogether.

Testing less frequently will reduce the number of false-positive results and unnecessary—and often painful—follow-up procedures. And studies show that the death rate for cervical cancer is not affected by lengthening screening intervals; in fact, half of the women who get cervical cancer have never been screened. So while cervical cancer screening is still crucial, patients should not be alarmed by the increased screening intervals.

As always, listen to your body. And if you have any signs or symptoms that worry you—in particular, abnormal vaginal bleeding, bloody discharge, pelvic pain or pain during intercourse—make an appointment with your doctor.

Average risk recommendations
The ACP says that people at average risk for developing colorectal cancer should get their first screening at age 50. There are a few of screening options recommended including a stool test, flexible sigmoidoscopy or traditional optical colonoscopy. The latter two screenings require a narrow tube with a camera to be inserted into the rectum. All of these tests are considered effective at preventing colorectal cancer in patients with average risk.

High risk recommendations
Those with inflammatory bowel disease, a personal history of polyps, or whose parents, siblings or children have been diagnosed with colorectal cancer are considered to be at increased risk and should have their first screening at age 40. African Americans are also considered to be at increased risk for colorectal cancer. The only recommended screening for this group is an optical colonoscopy.

No screening for people age 75 and older or who have a life expectancy of less than 10 years
The ACP says for this group, the potential harms of screening outweigh the potential benefits. It is ultimately up to your doctor, though, to make this decision.

Talk to your doctor about your medical historyAs a physician, it’s important for me to get a thorough medical history from each of my patients. This provides me with the critical information I need to determine the appropriate tests, treatments and screenings. So, please take the time to thoughtfully consider your medical history — your good health depends on it.

If you’re one of the many people who take a statin to reduce cholesterol, you’ll soon be seeing a new warning added to the medication’s label. It will now include language about increased risks of elevated blood sugar and possible transient memory and cognitive problems. Find out more after the break…

How significant were the findings?

While a recent trial of rosuvasatin (Crestor) showed a 27 percent increase in new onset diabetes, the data about cognitive problems is not as concrete. The FDA said that post-marketing adverse event reporting “generally described individuals over the age of 50 years who experienced notable, but ill-defined memory loss or impairment that was reversible upon discontinuation of statin therapy.”

Does the new label warning only apply to rosuvastatin?

No. the FDA said the label changes apply to the following statins:

• atorvastatin (Lipitor)
• fluvastatin (Lescol)
• lovastatin (Mevacor)
• lovastatin extended-release (Altoprev)
• pitavastatin (Livalo)
• pravastatin (Pravachol)
• rosuvastatin (Crestor)
• simvastatin (Zocor)

Should I stop taking my statin?

I certainly wouldn’t recommend that you stop taking your statin. These medications are quite effective in lowering cholesterol, which in turn may help reduce your risk of suffering a heart attack or stroke. The FDA even said it “continues to believe that the cardiovascular benefits of statins outweigh these small increased risks.”

If you’re in doubt, talk to your doctor

Virtually all medications have side effects. It’s important to be aware of these so that you can weigh the risks and benefits. As always, I recommend that you talk with your doctor before stopping any medication or otherwise altering a care plan.

A side note…

Even though the FDA has added new warnings to statin labels, it has removed a standing recommendation for routine liver function tests for patients taking cholesterol lowering drugs. The FDA judged the risk of liver damage to be “rare and unpredictable in individual patients.” Liver function testing is now only required before starting a patient on a statin.

A small study recently conducted by Georgetown University Medical Center found that patients with fibromyalgia may get a boost to their memories if they exercise several times a week.

Fibromyalgia is a disease that can cause widespread pain, fatigue, sleep and cognitive problems. It typically affects more women than men, and can be a difficult condition to treat.

Exercise has long been believed to be beneficial to those with fibromyalgia, helping to decrease pain. But this study marks the first time the cognitive benefits of exercise were measured.

At the beginning of the study, nine women were given a functional MRI test. They were also given memory tests and asked to describe their overall well-being and pain levels. Then, their fibromyalgia medications were suspended for six weeks.

They were given a second round of functional MRI and memory tests, and it was found that their memories worsened when they were off of the medication. Then, they started a regimen of aerobic exercise, 30 minutes a day, three times a week.

After they started exercising, the patients’ memory function returned to where it was before the testing began (when they were still taking medication).

More research is needed, and not every fibromyalgia patient is capable of exercising. But the bottom line is that there will be benefits from exercising for most people, whether they have fibromyalgia or not.

We’re in that time of year when New Year’s resolutions are made, and sometimes broken.  So often, those resolutions center on losing weight or getting more exercise.

There certainly is plenty of evidence to prove the benefits of exercises. Exercise can help you lose weight. It can boost your immunity so your body can fight off pesky illnesses like the common cold. It can reduce your risk of developing diabetes, cancer, heart disease and obesity.

But something that recently caught my eye was research that demonstrates that exercise can actually boost your brain’s cognitive abilities.

Researchers in Ireland assembled a group of young men, and quickly showed them the photos and names of a group of strangers.  After a break, the men were shown the photos again and asked to recall the names of the people pictured.

Half of the group then rode a stationary bike at increasingly strenuous levels. And the other half sat quietly for 30 minutes. At the end of that time, they took the test again.

The group that exercised performed significantly better on the test the second time than the group that didn’t exercise.

The reason seems to come from a chemical called BDNF. During the experiment, blood samples were taken and they found that the cycling participants had much higher levels of brain-derived neurotrophic factor (BDNF), which is known to promote the health of nerve cells. The men who sat quietly during the experiment didn’t have a comparable change in BDNF levels.

There are other research studies to support this too, like one out of Brazil that found elderly rats who exercised as little as five minutes several times a week had an increase in BDNF and could perform as well as much younger rats on memory tasks.

More research is needed to determine how much exercise, how often and how strenuous it needs to be. But no matter what, virtually any level of exercise will benefit you…body AND mind.