Wednesday Bubble: breast cancer during menopause- move your body

[Credit: Stephen diFilipo, Fountain at the Gaylord Hotel, National Harbor ©2009. With permission]

October is National Breast Cancer month. In honor of family and friends who have survived breast cancer, I am dedicating this month’s Bubbles to posting choice bits of information about the topic this month. I admire these women greatly – for their strength, their tenacity and their hope. Rock on ladies!

Nothing like a bit of good news to kick off the month!

Early this year, I wrote about a study showing that exercise could help reduce breast cancer risk. Today’s post provides evidence that the timing and intensity of that activity makes a huge difference.

In this study, which appears in BioMed Central Cancer, researchers examined and compared the relationship of light physical activity to moderate to vigorous activity and its association to breast cancer risk in 118,699 women in menopause. Activity levels were studied during four periods of life: ages 15 to 18, ages 19 to 29, ages 35 to 39 and the past 10 years. Light activities included bowling, golf (riding in a cart), table tennis, slow walking/slow dancing, light calesthenics, light gardening, fishing, horseshoes/croquet and light housework. Moderate-to-vigorous activities included tennis, golf (walking), biking, swimming, heavy gardening, weight lifting, basketball/baseball, football/soccer, cheerleading/drill team, handball/raquetball, hiking/mountain climbing, fast walking/fast dancing, rowing, aeroboics, jogging/running and heavy housework.

The researchers found no association between activity intensity and breast cancer risk in the time periods leading up to menopause. However, Women engaging in more than 7 hours per week of  moderate to vigorous activity during the past 10 years had a significant, 16% lower risk of developing breast cancer compared to women who were inactive or only engaged in light activity. This benefit remained even when the researchers took factors such as age, body mass index, family history, or hormone use into consideration. The type of tumour cancer stage also had no effect.

Although researchers have been aware that a high versus low level of physical activity may protect against developing breast cancer during menopause, this is the first study to actually examine activity during other time periods and then compare them to more recent time periods.

Clearly, it’s time to move your body if you’ve not been doing so. A 16% reduction in breast cancer risk is significant.

Extreme makeover

Great news for women in menopause: it appears that vigorous physical exercise can turn back the clock, at least as far as physical capacity and weight loss ability goes!

Findings from two studies, one published this past July in the Journal of Applied Physiology, and the other this September, in  Metabolism – Clinical and Experimental, show for the first time that despite age-related deceases in hormone levels, lean body mass and aerobic capacity, training can achieve the same health benefits that women 16 years younger might experience.

In both studies, researchers looked at the effects of cycling (on a stationary bike) for an hour, five days a week at 65% of maximum lung capacity in 10 sedentary but otherwise healthy postmenopausal women.

(FYI: The term ‘lung capacity’ refers to the maximum amount of air that a person’s lungs can hold after the greatest possible inspiratory effort. When you exhale, the amount of air left in your lungs is known as ‘residual volume.’ This can be affected by age, aerobic capacity and a host of other factors. After the age of 30, the capacity to use and consume oxygen drops by about 1% per year)

In the first, they found that all study participants increased their body’s capacity to consume and use oxygen (known as VO2max) by as much as 16%. At the same time, resting heart rate decreased an average of 4 beats per minute. By the study’s end, blood pressure had also dropped substantially and  heart capacity during exercise increased. What’s more, study participants were able to burn fat more efficiently — by about 10%, without relying on carbohydrates. (A primary reason why weight loss can be difficult for women with specific dietary changes is that unlike men, blood sugar (glucose)  levels (usually derived from stored carbohydrates) remain stable during exercise and metabolism quickly returns to normal after. So despite vigorous training, weight may remain the same.  This is even more true for women going through menopause, as fluctuating hormone levels affect metabolism and the ability to clear glucose from the blood.)

Similar findings were also seen in the second study; not only were women able to consume and use oxygen more significantly, but their ability to metabolize glucose improved by 35%, without any changes in dietary habits.

Overall, these study findings suggest that “older” women can improve and make significant changes in their cardiovascular and metabolic capacities, often to the same extent as women substantially younger, without having to go on extreme diets! The researchers say that these results are also encouraging in terms of increasing overall energy levels and keeping risk for disease in check.

Granted, the training regimens that the study participants undertook were quite strenuous and required a commitment, both in terms of time and exercise frequency. Nevertheless, the researchers believe that even less strenuous exercise could likely produce some degree of benefit.

So, do you need an extreme makeover to realize better health? Not really! Just a bit of inspiration and some kick-ass music to keep you going at the gym. Nice to know that great benefits can be achieved without starving ourselves!

Balancing act

We all know that aging is associated with a decline in balance. But can it also foretell a decline in muscle strength? Apparently so. At least in so far as hormones go.

Reporting in the Publish Ahead of Print issue of Menopause, researchers say that the stage of menopause can predict your physical prowess. 979 women between the ages of 43 and 57 underwent evaluations for flexibility (stand and reach, sit and reach), muscle strength (grip and pinch) and balance (one legged standing with eyes open or closed) to determine their physical performance. Among the study participants, 44.4% were premenopausal, 25.8% in perimenopause and 29.7% in postmenopause.

While the results did not reveal any differences in flexibility among the women, they did show that women in perimenopause or postmenopause had significantly weaker grip strengths than their premenopausal peers. What’s more, their ability to stand and balance was significantly shorter by approximately 20 seconds. These differences remained even after the researchers adjusted for factors that might skew the results.

Life is undoubtedly a balancing act and trying to squeeze an exercise regimen into an otherwise overcrowded life can be difficult. However, this study suggests that the earlier we engage in physical activity, the more likely it is that we can overcome some of the inevabilities of menopause.

The BOSU® trainer is a relatively affordable and low-impact way to build core strength and improve overall balance. Personally, I’ve been using it for years now and have experienced a noticeable difference. My dad, who is 82, also uses the BOSU and likes it immensely.  Tai Chi may also help to promote balance while also reducing stress. Grip strength can be tackled through exercises that strengthen the forearms, e.g., squeezing a tennis ball or forearm curls. An intensive listing of forearm exercises can be found here, although like any physical activity, it’s best to speak to a trainer or a healthcare professional before embarking on any new activity.

I am a firm believer in an ounce of prevention. The earlier we start using, the later we start losing. In this case, more is less for sure!

Just when you thought it was safe…

Researchers now say vasomotor symptoms, such as hot flashes, night sweats and sleep disturbances, can last more than five years after menopause ends.

Clearly, this has a lot of implications of how we approach therapeutic interventions for hot flashes and other symptoms, as well as for planning ahead.

In this study, which is published on the advanced online edition of the journal Menopause, data were colllected from 438 menstruating women (ages 45-69 years) and then analyzed over a period of 13 years.

The findings showed that the mean duration of hot flashes over the study period was 5.5 years, regardless of whether or not women had ever used hormone replacement therapy. What’s more, study participants started experiencing hot flashes around age 53, and roughly a quarter of them continued to report having symptoms after the 13 year endpoint.

Importantly, the one factor that was associated with a shorter duration of hot flashes was exercise, with more exercise/physical activity associated with shorter symptom duration.

I’ve posted previously about the benefits of exercise and physical activity, which range from positive effects on bone health, sleep and mood to heart health and of course, overall symptoms. This study suggests an even more important reason to keep moving: slowing and perhaps eliminating menopausal symptoms sooner rather than later.

Move your bodies ladies – the evidence is in and it says it’s safe to step back in, one foot at a time.

Poor man’s plastic surgery, and even better!

Exercise! Benefits aside, loved this poster! But that’s not the reason for this post.

Not only can exercise help improve mood and keep bones strong during menopause, but it appears that physical activity after menopause may help to lower the risk for breast cancer. Yet another reason to keep moving that body of yours.

German researchers evaluated the health records from 3,414 postmenopausal women who were participating in a study on breast cancer. Physical activity (sports, cycling, walking) was assessed during two periods — ages 30 to 49 and over age 50 — and compared to non-recreational physical activity (occupational, household activities).

Study findings showed that physically active women had a .71 lower odds of developing breast estrogen and progesterone receptor positive breast cancer. A similar effect was not seen on estrogen/progesterone receptor negative cancers.

Notably, these results remained even after the researchers took into account weight gain, body mass index and caloric intake, leading the researchers to conclude that continuing to be active after menopause may help to reduce the risk of developing certain breast cancers. This effect appears to be related to specific hormonal pathways and not body composition.

The study was published in the December 1 issue of Cancer, Epidemiology, Biomarkers & Prevention.

Strong motivation to keep moving, right?!

Wednesday Bubble: Restraint is the new black

Taking a restrained approach to eating may help to keep extra pounds and body fat away in middle age.

Sounds pretty dicey right? Especially since conscious restriction of calories has long been thought to lead to loss of control and binge eating.

Yet, results of a novel study published in the January 3 issue of the American Journal of Health Promotion suggest that women in midlife who do not restrict their eating have more than twice the risk of gaining substantial amount of weight than their peers who do.

In this study, researchers from Brigham Young University followed 192 women (mean age 40+3 years) over a three-year period, tracking their body weight, body fat, energy intake and physical activity at regular intervals.

Over the entire study period, and compared to their peers, women who did not restrain their eating had:

• a 69% greater risk of gaining more than 2.2 pounds
• a 138% greater risk of gaining more than 6.6 pounds
• a 49% greater risk of gaining more than 1% point in overall body fat

What’s more, the risk remained despite adjustments for age, weight, restrained eating, caloric intake and physical activity at the start of the study, and changes in caloric intake and physical activity during the study.

The researchers concluded that women who do not become more restrained in their eating habits or become more prone to emotional eating, are likely to gain both weight and body fat over a relatively short period of time.

While these data seem counterintuitive to a healthy relationship with food, the message is clear:  because our metabolism slows in midlife, we either have to cut calories or increase physical activity (or both).

Keep in mind, however, that any major change in your diet or exercise requires a conversation with a healthcare practitioner and certified trainer to insure that you are on the right track, and not heading into the injury jungle.

Makes sense, right?

Last year, I wrote a post about the need to move your body AND restrict caloric intake.  In fact, if you click on the word “exercise” in the tag cloud, you can access quite a bit of information about exercise during the menopause.

Awake again…naturally

[Pablo Picasso, Sleeping Woman]

When was the last time you slept through the night? Depending who you are, the stage of menopause you’re in and well, your symptoms, the answer to that question can vary. Add stress to the mix and it adds up to a lot of lost zzzs for some of us.

Experts continue to be challenged by the “s” word when it comes to the transition, with numerous recommendations ranging from yoga to hormone therapy to black cohosh to exercise to deep breathing. But again, whether or not these steps work depends on you.

I decided to delve a bit deeper into this issue and what I’m finding are many studies that don’t necessarily jive with each other. One of the latest bits of research comes from Brazil and is published in the November issue of Maturitas.

In this 6-month study, researchers examined two postmenopausal women with insomnia. Each woman participated in indivdiual therapy programs involving 1.5 hours/biweekly sessions comprising stretching, strengthening, massage and relaxation.

One woman experienced significant increases in REM and total time spent asleep, while the other had a reduction in the time it took to fall asleep and enter the initial stages of sleep (non-REM).

Both woman reported overall improvements in their insomnia.

Now mind you, I know a few women who have suffered insomnia most of their adult lives. So, I’m not certain whether or not exercise and/or relaxation truly improves overall sleep patterns when hormones and symptoms are wreaking havoc.  At the same time, however, I continue to see studies extolling the benefits of exercise and relaxation on sleep patterns, with very few reporting negative findings.

I’d love to hear your thoughts and what works or doesn’t work for you.

Let Joy be Unconfined… on Healthy Living Today

[Henri Matisse, Dance (II), 1909]

One never knows where one might find inspiration. It can in a song, a book, a beautiful friend or better yet, through common interests.

Someone I’ve met via Twitter has been a regular inspiration to me, through his devotion to exercise, fitness, healthy living and finding the positive in just about everything he does. Consequently, I was very honored to be asked by Mark Salinas to write a guest post for his blog, Healthy Living Today.

I hope you’ll check out the post and better yet, spend some time perusing Mark’s site. It a great source of information on how to make the best of the journey we’re all on.

Enjoy!

Train For Humanity

Exercise, while a blessing for some, is a bane for others. Personally, I enjoy my daily workouts (most of the time) and need some desperately for sanity, stress relief and peace of mind, not to mention weight control.

One of my BBFF, Blanche, has mentioned from time to time her desire to do a triathlon. She’s also said that there’s a bunch of women in her neighborhood who are training for one.

Although training for an intensive event such as a triathlon is not one of my personal goals, I did want to share information with you about an organization – Train for Humanity – that’s added a humanitarian twist to exercise.

Founded by a wonderful man named Mark Hayward, TFH is devoted to raising money for humanitarian organizations and aid relief missions assisting displaced persons and refugees, especially children who have been displaced due to genocide and/or civil war. The athletes that train for endurance events raise money simultaneously to support important causes donated to these issues.

If you’re in the mindset to step up your goals to balance out the hormones and mood swings and combine them with a bit of fundraising, well, I’m sure that TFH could use your help.

After all, what’s better than sweating for a cause instead of as the result of hormones?

Wednesday Bubble: Blue

Mid-life depression is a real issue. But are your blue feelings due to depression or to menopause? That is, is depressed mood in middle aged women a result of aging and some of the emotional or pyschological factors that accompanies it, or due to hormonal changes during the transition?

Experts still are not certain of the association and to date, research has demonstrated contradictory results, with some studies showing a correlation between depression and menopause and others, none. Other studies suggest mood declines during early stages of menopause followed by improvements as vasomotor and other symptoms start to wane.

However, what the data do appear to show is that there are several time periods in a woman’s life in which she is more vulnerable to depressive symptoms, e.g., pre-menstruation, postpartum and of course, during the menopausal transition.  What’s more, data from the Melbourne Women’s Mid-Life suggest that a prior history of depression and having negative feelings about menopause can increase risk. Additionally, menopausal-onset depression and the start of vasomotor symptoms during the early stages of menopause appear to be linked.

Personally, I believe that drastic changes in one’s body, in moods and appearance, as well as some serious self-exploration and self-analysis, also play a role.

So, what can you do when you feel blue?

Transdermal estrogen delivered via a patch that is applied to the skin appears to even out estrogen fluctuations that may affect mood during the menopause. For women for whom estrogen is not an option and who are not interested in trying antidepressants, (whose effects, btw, may vary depending on age), St. John’s Wort (hypericum) extract may be a viable and effective option. A recent analysis of 29 studies enrolling almost 5,500 patients showed that St. John’s Wort extract:

• is superior to placebo tablets in patients with major depression
• is as effective as standard antidepressants
• has fewer side effects than standard antidepressants

So, how should you take St. John’s Wort? Well, like any herb, it’s best to consult with a practitioner well-versed in herbal therapy rather than reaching for a bottle in your local drugstore. Many therapists are also joining the band wagon and may be able to provide advice.

In earlier posts, I wrote how exercise can help to improve mood symptoms. And ironically, a glass of red wine daily also has been shown to improve mood and quality of life, although if you’re taking medications for depression, alcohol is counterintuitive.

So, tell me? Are you feeling blue on a more regular basis? What seems to help (or not help)?