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Smoke, Early Menopause And Fertility

Women who smoke and those who have been exposed to second hand smoke have more problems getting pregnant and are more likely to reach menopause at an earlier age than women who never smoked or those who were exposed to the least amount of second hand smoke. A new investigation from Roswell Park Cancer Institute reached these conclusions after researchers analyzed data on nearly 89,000 women in the U.S. Women who reported smoking were 14 percent more likely to have infertility (meaning that they were unable to get pregnant for a year) and 26 percent more likely to reach menopause earlier than women who didn’t smoke. Those exposed to the most second hand smoke had an 18 percent increased risk of infertility and reached menopause at an earlier age than women exposed to the least amount of second hand smoke. The analysis didn’t prove that exposure to smoke was responsible for infertility or earlier menopause, although the researchers adjusted the data to account for other factors that could lead to infertility or early menopause.

My take? As lead researcher Andrew Hyland, Ph.D. acknowledged, earlier investigations have linked smoking to reproductive problems in women, but few looked at associations between second hand smoke, infertility and early menopause. But these are not the only smoke-related risks women face. Some studies have suggested that teenage girls who smoke are at increased risk of developing breast cancer before menopause, and by age 50 women who began smoking as teens had a risk of breast cancer that was 80 percent higher than others who chose not to smoke so early in life. In addition, women with a family history of breast and ovarian cancer may increase their own risks of developing these cancers if they smoke. In addition, women smokers are 1.5 times more likely to develop lung cancer than men. If you’re a female smoker, these unique risks to women are all compelling reasons to make a New Year’s resolution to quit now.

New Plus For Pilates

Pilates is best known as a sometimes intensive form of strength training that can help relieve back pain and build core stabilizing muscles. Now a small study from Spain suggests that the exercises can help older women with aching backs improve their balance, as well as reduce the fear of falling. Researchers at the University of Jaen followed 97 women over age 65 who were given two physiotherapy sessions per week that included 40 minutes of nerve stimulation plus 20 minutes of massage and stretching exercises. Half the women also took two hours of Pilates instruction per week. After six weeks, the women who performed Pilates reported a reduced risk of falling, a change that did not occur among the other women participating. The researchers also relayed that the women in the Pilates group had greater improvements in balance as well as less back pain than the others in the study. They tested the women’s balance with a timed test that required them to stand up from a chair, walk three meters (about 10 feet) turn, and sit down again. More studies are needed to evaluate the longer-term effect of Pilates on balance and whether or not the findings apply to younger women, the researchers said. 

Exercise Quickly Lowers Breast Cancer Risk

The risk of breast cancer diminishes rapidly after postmenopausal women begin to exercise, even if their daily activity is no more than a half hour walk. A study from France found that women who began exercising for at least four hours a week in the four years during which the data was collected had a 10 percent lower risk of breast cancer than women who didn’t exercise during that period. The risk of breast cancer also diminished in women who spent two hours a week cycling or engaging in other sports. However, the cancer risk was not reduced among women who reported performing this amount of exercise during five to nine years before they took part in the study, but who were less active during the four years of the study itself. The researchers noted that their findings addressed the question of how rapidly exercise impacts breast cancer risk and determined that the risk remains 10 percent lower in physically active women as long as they continue to exercise, but not after they stop. Earlier studies have shown that physical activity can also boost survival rates for women who have already been diagnosed with the disease.

Agnès Fournier et al, “Recent Recreational Physical Activity and Breast Cancer Risk in Postmenopausal Women in the E3N Cohort.” Cancer Epidemiology Biomarkers & Prevention, 2014; DOI: 10.1158/1055-9965.EPI-14-0150

Breast Cancer Drug May Work Best in the Dark

New research suggests that exposure to light at night may undermine treatment with Tamoxifen, a drug often prescribed to breast cancer patients after surgery to prevent recurrence of the disease. This finding came from a study with rats that demonstrated inadequate amounts of melatonin render breast cancer tumors resistant to the effects of Tamoxifen. The researchers noted that the same mechanism might be of concern in humans, and pointed out that even dim light in the bedroom can suppress production of melatonin, a hormone that influences sleep-wake cycles. The investigators didn’t pinpoint how much light may cause this effect, but suggested it could be as little as the amount that comes in a bedroom window from a street light. When they gave the rats a melatonin supplement, the animals’ tumors no longer resisted the effects of Tamoxifen. The researchers didn’t recommend that breast cancer patients take melatonin supplements, however, and raised the issue that taking the supplements at the wrong time of day could disrupt the natural cycle of melatonin production. It is darkness, not sleep, that triggers melatonin production. Sleeping in a dark room allows melatonin levels to rise normally, whether or not you’re taking Tamoxifen.

Steven M. Hill et al, “Circadian and Melatonin Disruption by Exposure to Light at Night Drives Intrinsic Resistance to Tamoxifen Therapy in Breast Cancer,” Cancer Research, doi:10.1158/0008-5472.CAN-13-3156

Less Red Meat for Less Breast Cancer

The less red meat a woman eats, the lower her risk of breast cancer. That conclusion comes from data on almost 89,000 women between the ages of 26 and 45 participating in the 20-year Nurses Health Study. Results of the analysis showed that the risk of breast cancer began to rise when women ate 1.5 servings of red meat a week. Just that extra half serving bumped up breast cancer risk by 22 percent, the study found. Each additional daily serving of red meat seemed to increase the risk by another 13 percent. The review also showed that replacing a daily serving of red meat with fish, legumes, nuts, poultry or a combination of those foods appeared to lower the breast cancer risk by 14 percent. Switching from a serving of red meat to one of poultry cut the risk by 17 percent overall and by 24 percent among postmenopausal women. This study doesn’t prove that eating red eat causes breast cancer. Rather, it shows an association between eating red meat (or not eating it) and breast cancer risk.

Maryam Farvid et al, “Dietary protein sources in early adulthood and breast cancer incidence: prospective cohort study,” BMJ 2014; 348 doi: (Published 10 June 2014)

Biggest Risk Factor for Heart Disease in Women Over 30?

You might guess the answer is smoking, high blood pressure, or being overweight, and all those contributors play a role, but a new study from Australia has shown that lack of physical activity presents the most significant risk of heart disease in women over 30. The researchers used a mathematical formula to determine reductions in heart disease if specific risk factors were eliminated, and followed more than 32,000 women in three age groups to arrive at their conclusion. Predictably, in women under 30, the biggest risk turned out to be smoking, but in all the women over 30 lack of physical activity proved the strongest risk. For women in their 70s, being active would lower the risk of heart disease nearly three times as much as quitting smoking and significantly more than lowering blood pressure or reaching a healthy body weight, the study showed. Overall, it found that for all women over 30 those who are inactive were nearly 50 percent more likely to develop cardiovascular disease in their lifetimes than women who regularly get at least 150 minutes of moderately intense exercise every week.

My take? Women often don't realize that heart disease is as much of a threat to them as it is to men. True, the risk for men is higher when they're younger, but by the age of 65, the rate of heart disease in women equals that of men and is the leading cause of death in women, claiming nearly 500,000 lives per year (compared to about 40,000 for breast cancer, a disease women tend to fear more). This study’s findings emphasize the importance of daily physical activity for lowering women’s risk of heart disease. About 60 percent of American women don't get the recommended 30 minutes per day of moderate exercise. While a sedentary lifestyle may be the biggest risk, the others – smoking, high blood pressure, high cholesterol and being overweight – shouldn’t be ignored.

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Wendy J. Brown et al, “Comparing population attributable risks for heart disease across the adult lifespan in women,” British Journal of Sports Medicine, doi:10.1136/bjsports-2013-093090

Danger at the Nail Salon?

Although it's unlikely, it remains possible that women could develop skin cancer from too much exposure to ultraviolet (UV) light while their nail polish or gel manicures dry, and there have been a few rare case studies where women did develop non-melanoma, squamous cell skin cancer on areas of their hands that were repeatedly exposed to UVA light used in nail salons. To get a better sense of the possible danger, researchers from Georgia Regents University did a random sampling of lamps in 17 nail salons to see how much UV radiation is emitted when nails are drying. They found a wide variation ranging from “barely” to “significant,” said study lead author Lyndsay R. Shipp, but reported nothing to warrant anything more than caution. Previous studies have noted that the exposures to salon lamps are likely not significant contributors to increased risks of skin cancer, and Shipp notes she uses the UV machines at the nail salon every few months and will continue to do so. “You can get that amount of exposure when driving down the road in your car,” she told The New York Times.

Deborah F. MacFarlane, and Carol A. Alonso, “Occurrence of Nonmelanoma Skin Cancers on the Hands After UV Nail Light Exposure,” Archives of Dermatology, 2009;145(4):447-449. doi:10.1001/archdermatol.2008.622.

Lyndsay R. Schipp et al, “Further Investigation Into the Risk of Skin Cancer Associated With the Use of UV Nail Lamps,” JAMA Dermatology, doi:10.1001/jamadermatol.2013.8740

How Not to Help Young Girls Lose Weight

Telling a young girl that she’s fat may backfire on your good intentions and put her at risk of obesity in her teens. A new study from UCLA checked the weights of more than 2,300 10-year-old girls in California, Washington, D.C. and Cincinnati. The researchers noted that at the start of the study 58 percent of the girls reported that they had been told they were too fat by a parent, sibling, teacher, classmate or friend. When the researchers went back to check the girls at age 19, they found that the ones who had been told they were too fat years earlier were 1.66 times more likely to be obese than other girls in the study. This held true even after the researchers factored in the girls’ actual weight, their income, race, and when they reached puberty. “We nearly fell off our chairs when we discovered this," said study senior author A. Janet Tomiyama in a UCLA press release. When people feel bad, they tend to eat more, not decide to diet or take a jog, she said. Making people feel bad about their weight could increase their levels of cortisol [the stress hormone], which generally leads to weight gain.

A.J. Tomiyama and J.M. Hunger, “Weight Labeling and Obesity: A Longitudinal Study of Girls Aged 10 to 19 years,” JAMA Pediatrics, doi: 10.1001/jamapediatrics.2014.

Can Vitamin A Prevent Breast Cancer?

Sweet potatoes and carrots provide us with carotenoids, including beta-carotene. Our bodies convert these naturally occurring compounds to vitamin A, and new research suggests that one form of these derivatives, retinoic acid, may help protect against breast cancer. A study from Thomas Jefferson University in Philadelphia showed that exposing pre-cancerous cells to retinoic acid turns them back into normal cells with a normal genetic signature. No such effect was seen when the researchers exposed cancerous and aggressive breast cancer cells to retinoic acids, which the researchers said suggests a small window of opportunity for retinoic acid to play its cancer-protective role. They also reported that lower concentrations of retinoic acid than the one used in this study had no effect and that higher doses actually yielded a smaller effect. Now, the researchers plan to investigate whether the amount of retinoic acid used will work in animals. If it does, human tests of the effects would come next. In addition to carrots and sweet potatoes, foods that contain carotenoids include broccoli, squash, cantaloupe, mangos and apricots, while vitamin A as retinoic acid can be found in beef liver and other organ meats, salmon, dairy products and fortified breakfast cereals.

M.F. Arisi et al, “All trans-retinoic acid (ATRA) induces re-differentiation of early transformed breast epithelial cells,” International Journal of Oncology, DOI: 10.3892/ijo.2014.2354, 2014.

Female Fertility: The Stress Factor

When pregnancy just isn’t happening, the problem could be a stressed-out prospective mother. A new study from Ohio State found that an enzyme that signals stress shows up more often in the saliva of women who fail to conceive after 12 months of trying than in women who have less trouble getting pregnant. The researchers followed 500 American women age 18 to 40 who had no known fertility problems when they began trying to conceive. The women were followed for 12 months or until they became pregnant. Researchers took saliva samples when the study began and again in the morning after the first day of the women’s first menstrual period after joining the study. Those who had higher levels of alpha-amylase were 29 percent less likely to conceive each month and twice as likely not to conceive after trying for a year. An earlier study in the U.K. concluded with the same results. The Ohio State researchers noted that stress is not the only or the most important impediment to pregnancy, but suggested that women who are having trouble getting pregnant consider stress-management techniques including yoga, meditation and mindfulness.

C.D. Lynch et al, “Preconception stress increases the risk of infertility: results from a couple-based prospective cohort study—the LIFE study,” Human Reproduction, doi: 10.1093/humrep/deu032