Vitamin D and Breast Cancer

Adequate serum levels of Vitamin D have been associated with decreased risk of several cancers, including breast cancer. Why? Some studies have shown vitamin D inhibits the formation of malignant breast cells. Regardless of the mechanism, KD Crew and associates recently published an abstract on line that indicates vitamin D levels are inversely related to breast cancer risk.

This population-based, case-controlled study compared vitamin D plasma levels of 1,026 women diagnosed with breast cancer between 1996 and 1997 with vitamin D plasma levels of 1,075 women who lived in the same area of Long Island, New York.

The authors found:

• Plasma vitamin D levels were inversely related to breast cancer risk


• All women with vitamin D levels greater than or equal to 40 ng/mL were 46% less likely to have breast cancer than women with vitamin D levels less than 20 ng/mL


• Postmenopausal women benefited most with a 54% reduction of breast cancer risk if their serum vitamin D level was greater than or equal to 40 ng/mL

These results add to a growing body of evidence that adequate vitamin D stores may prevent breast cancer development. It is known that circulating vitamin D levels of more than 32 ng/mL are associated with normal bone mineral metabolism; this data suggest that the optimal level for breast cancer prevention is greater than or equal to 40 ng/mL. More clinical trials are urgently needed to evaluate the role of vitamin D supplementation on breast cancer prevention.

What I tell my patients

It is unknown, as of yet, the optimal plasma level of 25-hydroxyvitamin D. Evidence continues to mount that our previous perception of "normal" levels of vitamin D falls short. Many experts now believe that a range of 40 to 80 ng/mL is an optimal range to protect us from many chronic and debilitating illness. However, many labs still report a 25-hydroxyvitamin D level as "normal" when it falls in the range of 20 - 100 ng/mL. Have your levels tested. Ask your doctor what your 25-hydroxyvitamin D level is. I recommend a level of 52 - 80 ng/mL to my patients (colon cancer risk is cut in half at 52 ng/mL).

Do self-breast exams monthly. Get annual mammograms starting at age forty; sooner if advised. Get 20 minutes of sunshine (without sun block) at least 3 days per week. Eat a diet abundant in vegetables, fruit, whole grains and omega-3's. Eat organic, when possible. Exercise regularly. Limit alcohol consumption to no more than 1 drink per day. Laugh often. Enjoy nature. Practice silence. And, be your own best health advocate.

Reference: Crew KD, et al. Association between Plasma 25-Hydroxyvitamin D and Breast Cancer Risk. Cancer Prev Res (Phila Pa). 2009 May 26. [Epub ahead of print]

Lemon Baked Halibut

Recipe from Dr. Andrew Weil's Daily Tips

Description

The mellow flavor of this low-fat fish comes from marinating it in vigorous spices. After cooking, it is topped with homemade salsa rich with the flavor of tangy onions, fiery jalapeño peppers, and cool papaya. Make the salsa first, before you start preparing the fish. It is also best to make the marinade far enough in advance so that the flavors can blend together for at least 2 hours before you actually marinate the fish in it for 30 minutes. Keep this in mind when deciding what time you want to serve this dish. I couple this entrée with a side of steamed vegetables or Roasted Root Vegetables.

Ingredients

PAPAYA SALSA 1/2 cup cilantro leaves 1 cup cubed papaya 1/4 cup cubed red bell pepper 1/4 cup diced red onion 1 small jalapeño pepper, seeded and minced 2 tablespoons freshly squeezed lime juice MARINADE 3 tablespoons freshly squeezed lemon juice 1 tablespoon grated lemon zest 1 tablespoon olive oil 1 tablespoon grated fresh ginger 3/4 teaspoon freshly ground black pepper 1/2 cup minced fresh cilantro Six 6-ounce halibut steaks, sliced in half lengthwise 3 medium bulbs fennel, trimmed and sliced 2/3 cup purified water 9 black or white peppercorns

Instructions

Make the salsa: Put the salsa ingredients in a small bowl, mixing with a spoon until everything is thoroughly melded in. Cover and refrigerate until you are ready to use. Make the marinade: Stir together the lemon juice, zest, oil, ginger, pepper, and cilantro in a bowl. Let the flavors mingle together for at least 2 hours, covered, in the refrigerator. After the 2 hours, put the fish in a baking pan, pour the marinade evenly over it, and let it sit for 20–30 minutes, covered, in the refrigerator. Preheat oven to 400°F. Meanwhile, cook the fennel in the water with the peppercorns in a large, flameproof sauté pan, covered, over high heat for about 6–8 minutes, until just tender, adding liquid if necessary. Remove from the heat. Remove the halibut steaks from the refrigerator and bake them for 5 minutes on each side. The halibut should be flaky and white. Arrange equal portions of the fennel on each of 6 plates, put the halibut on top, and spoon 1 tablespoon of Papaya Salsa on the fish. Serves 6 Per serving: Calories 322 Fat 7.1 g Saturated fat 1 g (20.2% of calories from fat) Protein 39.6 g Carbohydrate 24.4 g Cholesterol 54 mg Fiber 7.9 g This recipe is from The Healthy Kitchen - Recipes for a Better Body, Life, and Spirit (Hardcover) by Andrew Weil, M.D. and Rosie Daley (Knopf)

My Husband Rocks: 2nd edition

So last a couple of Wednesdays ago, my husband did something (I can’t even remember what it was) and he made the comment of “I bet THAT won’t make it on your next Friday MHR post”. I had to laugh. Maybe, just maybe, making him aware that I appreciate him makes him want to do even more nice little gestures to show his love. I guess that what we’ve always said about children may be true for adults as well: if you want to get a certain type of behavior from them, model that type of behavior.

So in this Friday’s installment of “My Husband Rocks” I’m not going to regale you in all the fascinating and wonderful things he did for me this week. Nope. Instead, I’m going to point out a few of the finer nuisances of my husband that make him so special to me.

One of my favorite things about my husband is that not many people truly understand him. I was talking to a friend of mine last week and she mentioned that Chuck and a friend were having a conversation around her and it was so completely over her head. Then when they tried to explain it…it was still over her head. I know it’s weird, but I like that about Chuck. I like that not many people understand his wit (and trust me, he is witty) nor his thoughts (and he is a thinker). I like that I totally understand him though. It’s like we have our own personal world…and our own jokes. Like when one of us yells out “dog pooping!” and then he and I die laughing while everyone else looks at us like goons.

But beyond our silly little inside jokes, I know the wonderful, sentimental, thoughtful, introspective person that is inside that gruff exterior. When my mom first met Chuck the first thing she said about him was "the arrogant cocky S.O.B." (this, of course, was the moment before I told her I was dating him.) But, that part...the arrogant, aloof, condescending person is the person that most people do see. (My mom has since changed her tone.) I get to see the other part...granted, not all the time...but I do. And I feel so fortunate to be married to someone who steps back and takes a look at his own relationship with his son and question it for the better, makes a scrapbook for me of when we first started dating and included the Seven Bridges Rd lyrics as a definition of our journey together (and labels Zachary as the "bridge between our hearts"), sets up exquisite surprises for me for my special days, and asks me out for our first date with roses and a blueberry 3 wick candle set up in my cabin.

My husband rocks because he allows me to see that side of him. He thinks enough of me to let me see the other side to the arrogant S.O.B. We get each other’s humour, sarcasm, thoughts and needs (especially in the bedroom!) Even though, sometimes, even I don't know what he's thinking until he puts it into words...he's definitely a complex man.

In short, Chuck rocks because we “get” each other. And I love him for it.

Hump Day Help

So, I’ve decided that I want to do a little column every Wednesday entitled “Hump Day Help” which would feature a different concern regarding sexual health or having a positive outlook on your sexuality.

Why?

Because I believe there are a lot of people out there that have issues regarding their sexuality (especially women) or with having sex in general and suffer in silence. I did until I met my husband who helped me to realize that it’s okay to be ME. He helped me to understand and accept myself. I know there are a lot of women out there that felt like I did in my late teens/early twenties who don’t have the support or understanding. Some of the women are even much older than I was when I started to embrace my inner sexpot. And I want to help more women find that for themselves.

So, I’d been thinking and planning and wondering about what my first post would be for Hump Day….when I got an email from Pure Romance corporate that Pure Romance was featured on the Tyra Banks show. The show was entitled “Married Virgins”. I seriously stopped and re-read it, thinking I’d read it wrong.

I knew that there were women out there that had pain and extreme uncomfortableness during sex, but was unaware of a disorder called vaginismus. (See, I still have TONS to learn!) I figured if I was unaware it’s a good chance that others are as well and if you’ve found my blog and have this condition, I hope to help you a bit.

So, what exactly is vaginismus? Basically it is involuntary muscle spasms of the pelvic muscles surrounding the vagina. It’s not as if the woman is willing the contractions to happen; in fact, she may not even know that they are occurring until there is painful intercourse. According to vaginismus.com, this disorder is the most common cause of women remaining virgins through relationships.

The good news is that vaginismus is highly treatable. And that’s where the video from Dr. Debby Herbenick (author of Because It Feels Good: A Woman’s Guide to Sexual Pleasure and Satisfaction) on they Tyra show comes into play. In this video she talks about how vaginal dialators can help with vaginismus; and help women with this disorder to experience and enjoy sex, maybe for the first time. Dr. Debby worked closely with Pure Romance to develop their line of vaginal dialators.

How are vaginal dialators used to treat vaginismus? So glad you asked! The pelvic floor muscles are just like any other muscles and need to be used, stretched and exercised in order to be at their tip-top shape. Vaginal dialators are used to gently stretch those muscles and the vaginal tissue.

As with any exercise, you want to consult with your dr. before starting; however, it’s even more important when dealing with vaginismus. First, you want to make sure that you have a correct diagnoses and second, you’ll need to know what kind of regimen you should be following. Please see your dr. and discuss your concerns with him/her!! (I am in no way shape or form a medical professional!)

The most important things to remember when using…and choosing…a vaginal dialator set is:

*RELAX! Take a hot bath, drink a glass of wine, read a book…do whatever you need to do to relax.

*Get comfortable. Whether you’re most comfortable doing this in the shower/bath, in your bedroom or the living room couch, choose that spot.

*Find the best position for you. Most women find that lying on their back works the best.

*Use a quality water-based lubricant.

*Soft is good. When looking for a dialator set, you want to make sure that you get a soft and smooth set (with no ridges from the manufacturing molds!) that will be easy to clean and comes in graduated sizes. The Pure Romance set comes with six different sizes…no need to buy another set!

If you have a partner with this disorder, please understand that it is not a matter of wanting to have sex, but more a matter of a physical condition not allowing it to happen. There are other ways to have an intimate fulfilling relationship without penetration; let the dialators and Dr’s do their job so that you can experience it all with your partner. Who knows before too long she may be asking for you help with some insertions ;)

If you have any additional questions, check out vaginismus.com or email me. I’ll try to answer…or find the answer…to your questions. I’ll also be giving a 15% discount on the vaginal dialator set to any of my readers until 6/11/09.

Mayfair Renaissance Festival

So, after a Sunday of working hard at the in-laws on their lawn (Zachary worked his butt off, Lucas...not so much...I kept having to get after him since he wanted to play with his cousin who wasn't working) we took the kids to the RenFest today. I thought the kids might enjoy dressing up and being knights and princesses for the day.And I think they did have a good time. They got to watch a Fox Hunt (men doing silly things to be called the foxiest in all the land), the jester doing jester-ly skits and making balloon swords and hats and animals for the kids, and got to see all kinds of swords from real hand tooled steel to wooden ones that looked miraculously just like the real thing. Zachary and Lucas also got to try on chain mail which was amazingly heavy...I'm shocked that they didn't fall over from the weight of it! We made paper crowns encrusted with plastic jewels and a septor that m'Lady Elizabeth kept pulling jewels off from as soon as I'd glue them on. On the way out for the day, Zachary also played a game called "Drench the Wench" where all proceeds went to cancer research. He threw 3 wet sponges at the girls and in return he got big, red kisses on each cheek and nose. The girls gave him the choice of handshakes, hugs or kisses and of course, my boy being my boy, chose kisses...and blushed the entire time.
It's funny, because on the way home, Chuck and I were talking about if we felt the $60 for the gate entrance, food, and couple little trinkets we picked up was worth it and I felt it really wasn't. But seeing it in print, we did a lot of things this afternoon and the kids had a good time and were very well behaved. They had new experiences and a little education of how things worked in the past (we went through viking encampments and they watched a blacksmith at work) so it wasn't all lost. I just expected a bit more....renaissance. I think the addition of a jousting competition and sword fighting competition would have been neat.

In the future, I think we may go but eat a HUGE meal ahead of time and make a no trinket rule. Then it would only cost the $21 entry fee...and that's a much more reasonable price for us for an afternoon of wandering through the mid-evil mall.

Mindfulness Training to Enhance Female Sexual Response

Most women are accomplished multi-taskers. However, ruminating about grocery lists or an upcoming staff meeting while engaging in sexual activity could certainly prove to be detrimental. For a rewarding sexual experience, such moments deserve to be the sole focus of attention and concentration.

Mindfulness is rooted in Eastern spiritual traditions, and is described as the means by which dispersed thoughts are gathered so that the mind can experience "living in the moment". Mindfulness is commonly used in stress reduction programs and has been shown to have many positive effects on physical, emotional and sexual health.

In general, mindfulness therapy teaches a woman to focus on the present moment without judging the experience or clouding it with feelings. Women with sexual impairment often report difficulties with intercourse because of intrusive, nonsexual thoughts and concerns about sexual performance, body image and partner-related issues. A study published in 2000 showed that a mindfulness practice can help women overcome such distractions and focus on their sexual response (Dove, 2000). Another study demonstrated improved sexual desire, arousal and satisfaction and decreased negative mood in ten women who practiced mindfulness meditation for five years (Brotto, 2008). Mindfulness has also been correlated with greater marital satisfaction (Burpee, 2005).

You can find mindfulness meditation CDs by Jon Kabat-Zinn at http://www.mindfulnesscds.com/index.html

References:
1. Dove NL, Widerman MW. Cognitive distraction and women's sexual functioning. J Sex Marital Ther. 2000;26(1):67-78
2. Brotto LA, et al. A mindfulness-based group psychoeducational intervention targeting sexual arousal disorder in women. J Sex Med. 2008;5(7):1646-59.
3. Burpee LC, Langer EJ. Mindfulness and marital satisfaction. J Adult Dev. 2005;12(1):43-51.

U.S. Faces Epidemic of Vitamin D Deficiency

According to a recent report published in the Archives of Internal Medicine, a vitamin D deficiency epidemic has hit the United States and current recommendations for vitamin D supplements are inadequate. According to the National Health and Nutrition Examination Survey vitamin D deficiency has tripled since 1994. The analysis included serum specimens from 13,369 people ages 12-60 between 2001-2004 and compared them to 18,883 specimens obtained between 1998-1994.

Authors' observations:

• Vitamin D supplementation should consist of at least 1000 IU, especially during the winter months for those living in northern latitudes (i.e. above Atlanta, Georgia)
• Current recommendations for Vitamin D supplementation (200-600 IU/d) are too low
• It is unknown what the optimal serum level is for vitamin D - most likely above 40 ng/ml
• The average vitamin D level of people ages 12-60 was 24 ng/mL
  
• Vitamin D deficiency in the African American population is the highest at 29%
• Several factors contribute to vitamin D deficiency including decreased time outdoors, obesity and the use of sunblock. (SPF 15 decreases vitamin D synthesis by 99%)

What I tell my patients:

• Vitamin D deficiency contributes to osteoporosis, depression, diabetes, many forms of cancer, cardiovascular disease, multiple sclerosis, etc.
• 25-hydroxy vitamin D levels should be checked annually (optimally between November and April when levels are likely to be lowest)
• Those most at risk for vitamin D deficiency: elderly, people of color, people who are unable to get sun exposure, and those who routinely cover their heads when walking outside
  
• You need 20 minutes of sun exposure without sunblock 3 times per week for adequate vitamin D synthesis. Care should be taken to avoid sunburn.
• Thirty minutes of sun exposure in a bathing suits results in the formation of 20,000 IU of vitamin D
  
• Our food supply does not contain adequate amounts of vitamin D supplementation - not even dairy products
  
• Everybody, with very few exceptions, should be on vitamin D supplementation 1000 IU/d
• I recommend an optimal level of 52-80 ng/mL. One study demonstrated that a level of 52 ng/mL decreases your risks of colon, breast and ovarian cancer by up to fifty percent!
• Supplements of 1000 IU can be purchased without a perscription and are relatively inexpensive.

Reference:
Ginde AA, et al. Dmographic differences and trends of vitamin D insufficiency int he US population, 1988-2004. Arch Intern Med. 2009;169(6):626-632.