World Osteoporosis Day 2016: Foods That Can Lead to Bone Loss

World Osteoporosis Day 2016: Foods That Can Lead to Bone LossDid you know: Osteoporosis causes more than 8.9 million fractures annually across the world, resulting in an osteoporotic fracture every 3 seconds?

Dr. Manoj K. Ahuja, Fortis Hospital says, “Osteoporosis literally means porous bones. It is a disease wherein the density and quality of bones are reduced. As the bones become more fragile and porous, the risk of fracture increases. The loss of bone occurs progressively, and yet silently. More often than not, there are no symptoms until the first fracture occurs”.

“For people suffering from osteoporosis, bone loss outpaces the growth of new bone. Bones become brittle, porous and prone to fracture”, says Dr. Supriya Bali, Internal Medicine, Max Hospital, Saket. So, what causes osteoporosis?

Osteoporosis is associated with a set of factors including depletion in bone mass and density as a result of ageing, previous injuries, genetic inheritance, family history of osteoporosis, and arthritis. Women (especially those who have hit menopause) are more susceptible to this condition, as they often fall prey to the deficiency of calcium and vitamin D.

“Worldwide, 1 in 3 women over the age of 50 will experience osteoporotic fractures, as will 1 in 5 men aged over 50. Osteoporosis is estimated to affect 200 million women worldwide – approximately one-tenth of women aged 60, one-fifth of women aged 70, two-fifths of women aged 80 and two-thirds of women aged 90. Overall, 61% of osteoporotic fractures occur in women, with a female-to-male ratio of 1.6”, according to the International Osteoporosis Foundation.

The Role of Nutrition in Osteoporosis

Nutrition and osteoporosis are closely linked. Thus, it is important to learn about the foods that are rich in vitamin D, calcium and other nutrients to boost your bone health. “Good nutrition is also an important part of a successful rehabilitation program in patients who have had an osteoporotic fracture”,  according to the International Osteoporosis Foundation.

“The food that you eat affects your bones, so you must make healthier food choices every day and eat a well-balanced diet with plenty of dairy, fish, fruits and vegetables to get enough of the nutrients your body needs”, says Dr. Manoj K. Ahuja, Fortis Hospital.

What Should You Eat?

According to the National Osteoporosis Foundation, you must eat dairy product such as low-fat and non-fat milk, yogurt and cheese, fatty varieties of fish such as salmon, mackerel, tuna and sardines, fruits and vegetables including collard greens, turnip greens, kale, okra, brussels sprouts, Chinese cabbage, dandelion greens, mustard greens, broccoli, spinach, beet greens, artichokes, plantains, potatoes, sweet potatoes, papaya, oranges, bananas, pineapples, papaya, prunes, red peppers, green peppers, grapefruits, strawberries and papaya. Recent research has also found that olive oil, soy beans, blueberries and foods rich in omega-3s such as fish oil and flaxseed oil may also have bone boosting benefits.

World Osteoporosis Day 2016 - 1

Foods That Can Lead to Bone Loss

The following foods can cause your body to lose calcium and result in bone loss, according to the National Osteoporosis Foundation:

1. Alcohol: Drinking heavily can lead to bone loss.

World Osteoporosis Day 2016 -2

2. Caffeine: Coffee, tea and colas may decrease calcium absorption and contribute to bone loss.

World Osteoporosis Day 2016-3

3. Beans (Legumes): While pinto beans, navy beans and peas contain calcium, they are also high in substances called phytates which interfere with your body’s ability to absorb the calcium present in beans. Tip: To reduce the phytate level, soak beans in water for several hours and then cook them in fresh water.

World Osteoporosis Day 2016-4

4. Wheat Bran: Like beans, wheat bran contains high levels of phytates as well. But unlike beans, 100% wheat bran is the only food that appears to reduce the absorption of calcium in other foods eaten at the same time. For instance, if you have milk and 100% wheat bran cereal together, your body can absorb some, but not all, of the calcium from the milk. However, the wheat bran in other foods like bread is much less concentrated and does not have a noticeable impact on calcium absorption.

World Osteoporosis Day 2016-5

5. Salty Foods: Eating foods that have a lot of salt (sodium) causes your body to lose calcium. So limit the amount of processed foods, canned foods and salt intake each day.

World Osteoporosis Day 2016- 6

6. Meat and Other High Protein Foods: It’s important to get enough protein, but not too much. Many older adults do not get enough protein in their diets and this may be harmful to their bones. However, special high protein diets which contain multiple servings of meat and protein can also cause the body to lose calcium. You can make up for this loss by getting enough calcium from dairy products as they are high in protein, but also contain calcium which is important for healthy bones.


There’s a Breast Microbiome, and It’s Different in Women with Breast Cancer

There's a Breast Microbiome, and It's Different in Women with Breast CancerAmong the most popular topics in biology in recent years is the human microbiome, the trillions of bacteria and other tiny organisms inside and outside our bodies that outnumber our own cells by as much as three-to-one. Much of the news on this topic has been about the colony of bacteria deep in your gut; scientists believe that the mix may contribute to all sorts of medical conditions ranging from Crohn’s disease, an inflammatory bowel disorder, to anxiety.

Now it looks like the microbiomes in other parts of our bodies may also play an important role in disease.

In one of the most recent studies, researchers from the Mayo Clinic have identified significant differences in the breast bacteria of women with and without breast cancer.

The paper, published in the journal Scientific Reports, reveals that inside the breast is a complex microscopic world much different from that of the skin tissue just outside. Researchers used DNA sequencing to analyze sterile breast tissue removed from 33 women in the operating room and compared the results to breast skin and cheek swabs taken from the same patients.

The tiny organisms contained within the breast of women who had benign breast disease – lesions and abnormalities that ended up not being cancerous – were dramatically different from those in samples taken from the same locations in women who did have cancer. Women with breast cancer had more abundance of a variety of bacteria such as Fusobacterium, Atopobium and Lactobacillus. And their skin microbiome just inches away seemed completely distinct.

“There were really striking differences between skin tissue and breast tissue,” said Tina J. Hieken, a Mayo Clinic breast surgical oncologist who led the study. Not only did breast skin have a different mix of bacteria, but the bacteria that lived there were more abundant.

Unlike previous breast microbiome studies, this study collected breast tissue from a sterile operating room environment. However, it did not collect breast tissue from women without breast abnormalities of any kind – the women who ended up not having invasive breast cancer, but entered the operating room because of breast disease. The researchers did test for the effects of menopause on the samples taken, but found no difference in the microbiome based on age or menopausal status.

Although the study points to the breast as a distinct microbial ecosystem of its own, it raises questions about exactly what the microbes – or lack thereof – might mean in terms of breast cancer.

“We don’t really know if it’s the presence or perhaps the absence of a certain bacteria that can confer risk or lead to the development of cancer,” said Hieken. “Or is it an entire bacterial community that is required?”

Fusobacterium, for example, has been associated with colorectal cancers, but Hieken said more research is needed to determine exactly how the two might be linked. “These bacteria might act by secreting virulence factors or by creating a pro-inflammatory environment,” she said. “We’d like to look at what’s really going on in the microenvironment of the tissue.”

Now, Hieken and her team are delving even further into the microbiome they’ve found. They plan to analyze the bacteria to try to tease out their role in developing, worsening or even slowing cancer. But she warned that, as with any project on the cutting edge of scientific research, “there’s a huge learning curve.” Although research into the gut microbiome has gained mainstream recognition and momentum through initiatives such as the Human Microbiome Project, fewer researchers have delved into the microbiome of human tissues.

To make significant strides, the research community will have to increase sample sizes and ensure reproducible results – and that can move at what seems like a snail’s pace. In the fight against cancer, time is a precious resource, especially given that breast cancer is the most common experienced by women.

“Could we have a microbial risk prediction signature?” Hieken asked. “Could we do better to predict risk for individual women?” Only time will tell – and that’s something oncologists could always use more of.


The Ultimate Guide to Gym Memberships: 7 Ways You Can Save Money

The Ultimate Guide to Gym Memberships: 7 Ways You Can Save Money
An estimated £3 billion is spent by British gym-goers annually to get into shape and it is a similar case in other countries as well. A large chunk of it goes into buying nutrition books, fitness DVDs, equipment and of course, gym clothing. The budget hits the roof in no time and when it comes to expensive gym membership, one only begins to cringe.Self-training or regular outdoor runs will always remain the best and most inexpensive ways to stay fit. However, for people with absolutely no history in fitness and a lack of that initial burst of motivation, hitting the gym can come in handy. Let’s face it, there is no dearth of fitness centres these days. The glossy, shiny glass walls let you see through and peek at people running on treadmills or breaking into crunches. You feel motivated and make your way to the reception. Just a look at the available packages shortens your smile, breaks your heart and makes you work up the monthly budget silently in your mind.

Join if you must, we present to you a few easy tips to save your from shelling that extra penny from your pocket and make the most of your fitness plan.

1. Go for the trial first

Many chains offer free trail classes for their potential members. It is a great opportunity for you to assess whether or not the service is worth the buck. Try all the services and facilities on offer and see how you fit in.

2. Pay as you go

It is always advisable to take up a plan which will enable you to pay for the number of days you go/per session. It may work out to be more expensive in the short term but comes with the advantage that you can cancel any time and save wasting your money otherwise invested in a long-term plan. It is a perfect way to try it all out before you commit for a year.

3. Rules for cancellation

Always take time to go through your contract and the terms and conditions of your membership. You should know if at all you can freeze your membership and renew it later or transfer it to someone else in the course of uncertain events.

4. Types of Memberships

Always skim through the kinds of membership plans available to you. Check if you can save money on student memberships or couple plans. Many fitness centres have separate tariffs for mid-morning or mid-afternoon training sessions, see if that suits you and if you can save money opting for any of those plans.

5. Discounts

Never shy from availing of a discount. Be watchful of discount codes and groupon-type websites. Many offer discounted gym membership codes for first-time customers.

6. Social media

Just before you sign up, make sure to check out the various social handles of your fitness center. There will be lots of happy, positive comments and testimonials if it is a great gym. Likewise, you will know if it doesn’t enjoy a likeable reputation.

7. Don’t be reluctant to ask

Don’t shy away from voicing your doubts. Seek help and resolve your queries. If you don’t understand the pricing structure, fees and overall contract, it is better to talk it through. Many gyms have their membership fee collection outsourced. So another company will chase you for payment in case you default. If this arrangement doesn’t make sense to you, maybe a cash 1/3 or 6 month payment would suit you better – which in most cases, is not refundable.



How to Get Rid of a Double Chin: 5 Easy Exercises

How to Get Rid of a Double Chin: 5 Easy ExercisesWhile we’re told that beauty is in the eye of the beholder, most of us look for some sort of reinforcement when we look at the mirror and having a double chin may rob your confidence. The good news is that you don’t have to undergo painful surgeries or expensive treatments to get rid of it. You can work on it the natural way. You may have not known but there are some simple exercises that you can do at home to combat a double chin. But first, why do some people get a double chin?
As time passes, your skin tends to lose collagen, a type of protein found in our body that holds the whole body together. When the skin loses this protein its elasticity tends to decrease causing the skin around the skin and neck to sag which usually starts to happen when you’re in your late 20s.
These five exercises will show you just how easy it is to get rid of a double chin.

1. The Big Smile
In her book, Face Exercises, Elizabeth Gilfillan tells us how a smile can help melt the fat under your chin. She explains, ‘Lie on your back without a pillow with knees bent up and feet resting on the bed. Open your mouth widely and then close it slowly while resisting the closing. Try to have a big, wide smile but don’t clench your teeth. While holding the smile, lift your head slightly and then put it down. Do this lifting 7 times.’

2. Stick Your Tongue Out
This is one of the easiest exercises that most people swear by.  Open your mouth wide and stick your tongue out as far as you can, hold it for few seconds and then slowly return it to your mouth. Do this at least 10 times.

tongue out

3. The Neck Roll
The neck roll is a great exercise that tones and stretches the muscles of your neck and jaw.  It is also good for releasing tension from shoulders and relives neck pain. Stand straight with an erect spine. Take a deep breath and turn your head on one side until your chin touches your shoulder. Slowly, roll your head downwards till your chin touches your chest. Repeat the same with the other side. Keep your spine and shoulders straight.

neck roll

4. Chin Up
Stand or sit keeping your spine straight. Tilt your head slightly back and look towards the ceiling. Pucker your lips tightly as if you are trying to kiss the ceiling. Hold this position for 5 seconds. Repeat at least 10 times.

5. Chin Slap
Face forward and gently slap your lower jaw with the back of your hand. Don’t be too hard. Do this constantly for about 30—40 seconds.

chin slapYoga trainer and founder of Yogisthaan, Ajit Singh Tapasvi explains, “Our ancient knowledge was all based on the energy. When your body’s energy gets trapped in a certain area it leads to fat accumulation. To get rid of it, you need to release the energy. Surya Namaskar not only invokes the energy of the sun within the body but also triggers all the energy points in the body. It is great for fighting a double chin and in fact, it is a full body workout that engages all muscles. It’s best to practice it under the sun before 10 am.”

You can also support the above exercises with some natural home remedies, for instance, massaging your lower jaw with wheat germ oil as it is rich in Vitamin E which helps in tightening your skin. Another quick remedy could be applying a mask made with egg whites, honey and lime. This also has a tightening effect on the skin. Give these exercises and remedies a shot and say goodbye to that double chin. No more shying away from being clicked!


Massive US Health Tab For Hormone-Disrupting Chemicals

Massive US Health Tab For Hormone-Disrupting ChemicalsExposure to tiny doses of hormone-disrupting chemicals is responsible for at least $340 billion (310 billion euros) in health-related costs each year in the United States, according to a report published Tuesday.

So-called endocrine-disrupting chemicals (EDCs) are found in thousands of everyday products, ranging from plastic and metal food containers, to detergents, flame retardants, toys and cosmetics.

Neurological damage and behavioural problems, including attention-deficit/hyperactivity disorder (ADHD), autism and loss of IQ, accounted for at least four-fifths of these impacts, researchers said in The Lancet Diabetes & Endocrinology, a medical journal.

The invisible but dangerous chemicals also boosted obesity, diabetes, some cancers, male infertility and a painful condition known as endometriosis, the abnormal growth of tissue outside the uterus.
The economic impact of the chemicals leaves a huge, two percent dent in the US’ gross domestic product (GDP) each year.

“Our research adds to the growing evidence on the tremendous economic as well as human health costs of endocrine-disrupting chemicals,” said lead investigator Leonardo Trasande, an associate professor at NYU Langone in New York City.

“This has the potential to develop into a much larger health and economic issue if no policy action is taken,” he told AFP.

The body’s endocrine tissues produce essential hormones that help regulate energy levels, reproduction, growth, development, as well as our response to stress and injury.

Mimicking naturally occurring hormones such as oestrogen and androgen, EDCs lock on to receptors within a human cell and block the body’s own hormones from binding with it.

– ‘Adverse consequences’ –

Recent research has raised red flags showing that “environmental contaminants can disrupt the endocrine system leading to adverse-health consequences,” according to the US Environmental Protection Agency.

In the US, the biggest chemical culprit by far among the thousands of manmade molecules suspected of interfering with human hormones are so-called PBDEs, found in flame retardants.

Bisphenol A, used to line tin food cans, along with phthalates in plastic food containers and many cosmetics, were also held to be responsible for upward of $50 billion worth of health damages.

A similar study concluded last year that health-related costs of EDCs in the European Union were some $271 billion, about 1.28 percent of GPD.

Crucially, the main drivers of disease and disability were different on either side of the Atlantic, Trasande said.

“US costs are higher mainly because of the widespread use in furniture of brominated flame retardants,” which were banned in the EU in 2008, he explained.

The blood level of these chemicals in the average American would be in the top five percent of Europeans today.

By contrast, the health costs associated with pesticides in food were 10 times higher in the EU than in the United States, where more stringent regulations were put in place to protect pregnant women and children.

To put a figure on the impact of EDCs, the researchers reviewed blood and urine samples from the National Health and Nutrition Examination Survey, which has gathered data since 2009 on major disease risk factors from 5,000 volunteers.

Computer models were then used to project how much each of 15 diseases or conditions was attributable to chemical exposure, and the estimated health costs for each one.

– ‘Cat-and-mouse game’ –

Flame retardants and pesticides in particular are known to affect the developing brain and can lead to loss of IQ.

“Each IQ point lost corresponds to approximately two percent in lost productivity,” Trasande explained.
The costs and benefits of regulation should be openly debated, the authors argued, citing the decision in the 1970s to ban lead in paint, and then 20 years later in gasoline.

Commenting in the same journal, Michele La Merrill, an expert in environmental toxicology at the University of California in Davis, said the new findings “provide a lesson on the lasting economic effects of harmful chemicals.”

They should “inspire a policy shift to end the cat-and-mouse game currently employed the US government and industry.”

The EU set broad criteria in June for identifying potentially harmful EDCs, but consumer and environmental groups said they fell far short of what is needed.


I Have Experienced Depression, Says Hrithik Roshan

I Have Experienced Depression, Says Hrithik RoshanBollywood star Hrithik Roshan says he has gone through a lot of ups and downs in his personal life and been through depression, but it is something which should not be stigmatised.

The “Bang Bang!” star says issues relating to mental health must be spoken casually and not as if it is something which can’t be cured.

“I’ve been through my ups and downs. I have experienced depression, I have experienced confusion, as we all do. It’s a very normal thing. We should be very casual about it when we speak about it. It should be spoken about casually,” he told reporters here.

The 42-year-old actor was speaking at the launch of M Power’s ‘Everyday Heroes’ campaign which urges people to accept and fight with mental illnesses.

Hrithik said the high and lows that he has experience were necessary as it helped him evolve as a person.

“I have experienced issue in my own personal life, we all go through ups and downs. The ups are important, the downs are (also) important because you evolve through both of them.”

“When you go through a down then the most important thing is clarity of thought. Sometimes your brain takes over, feeds you with unwanted thoughts.

“That’s the time you need objectivity, a third or second person to look at you and say ‘this is what is happening to you’,” said the popular Bollywood star who started his career with “Kaho Naa Pyaar Hai” in 2000.

The actor said he saw many of his friends silently battle depression and other mental issues which prompted him to dig deep into the matter.

“This is something which was on my mind for years. I always questioned this stigma (around mental illness). I have seen my friends suffer in silence and it bothered me to a level where I started asking questions and stumbled upon some very good questions in that search.

“About, why when we are suffering from stomach or kidney problem, we are so cool and casual about it. Why when we have a problem with brain, which is also an organ, we get scared and feel as if it is our fault and we need to hide it from people. Everybody at some point of life is going to go through some mental issue,” he added.


Sensor To Detect Vitamin B12 Deficiency In a Jiffy

Sensor To Detect Vitamin B12 Deficiency In a JiffyResearchers from University of Adelaide have developed a world’s first optical sensor that can detect vitamin B12 in diluted human blood – a novel step towards developing a low-cost and portable deficiency test.

Vitamin B12 deficiency is associated with an increased risk of dementia and Alzheimer’s disease.

Such a device would enable the tracking of vitamin B12 levels in high-risk patients and early intervention can help overcome the limitations of current testing methods which are time-consuming and costly.

“Vitamin B12 deficiency has been shown to be a potential modifiable risk factor for dementia and Alzheimer’s disease and is associated with cognitive decline,” said Dr Georgios Tsiminis, Research Fellow at University of Adelaide.

Older adults are particularly at risk of B12 deficiency due to age-related reduction in absorbing vitamin B12 received through their diet.

“Our sensor is an early step towards a point-of-care solution for measuring and tracking B12 in healthy ageing adults. This would allow doctors to monitor B12 levels and intervene as soon as B12 deficiency was detected,” Dr Tsiminis added.

The sensor is still at proof-of-concept stage but, with development, has wide-reaching potential applications.

The optical sensor measurement of B12 in human blood takes less than a minute and requires minimum preparation.

This is the first demonstration of vitamin B12 being measured in human blood serum without the need for a full laboratory test.

The sensor uses an optical measuring technique called Raman spectroscopy which produces a unique optical fingerprint of a target molecule, in this case vitamin B12.

“Our method provides a realistic basis for a system that is portable, cost-effective, and affords rapid results, along the lines of the pin-prick test for diabetes,” Dr Tsiminis noted in a statement.

The research by scientists in the ARC Centre of Excellence for Nanoscale BioPhotonics (CNBP), the Institute for Photonics and Advanced Sensing, and the Schools of Physical Sciences and Medicine was presented at an international biophotonics conference in Adelaide last weekend.


For Osteoporosis, Early Treatment Is Crucial

For Osteoporosis, Early Treatment Is Crucial
My neighbor Arlyn Riskind, who is 53, has premenopausal osteoporosis, diagnosed nine years ago. She takes low-dose birth control pills to preserve her bone mass and postpone menopause. But after menopause, she knows she “may be soon faced with some decision-making.” And she is quite anxious about it.

The source of her angst is whether to begin treating her osteoporosis with bisphosphonates, drugs that are very effective at increasing bone density but carry some small risks.

These include an increased chance of developing osteonecrosis of the jaw, in which the jawbone fails to heal after a minor injury – getting a tooth pulled, for example – and of suffering an uncommon type of fracture in the femur, or upper thigh bone.

While serious, these conditions are rare. Nevertheless, Riskind is nervous. “I’ve read all the latest studies about jaw problems and femur breaks, and want to avoid taking the drugs for as long as possible,” she says.

Bone specialists worry about women like Riskind because those who fail to treat their osteoporosis face a growing danger of a debilitating hip fracture as they age.

Osteoporosis develops when the body loses too much bone or makes too little of it, or both. When this happens, bones weaken and are susceptible to breaking from a fall, or even from something more benign, such as a bump or a sneeze.

About 54 million Americans have osteoporosis or osteopenia, according to the National Osteoporosis Foundation. The latter condition is a softening of the bone, which puts a person at higher risk of developing full-blown osteoporosis. The disease results in 2 million broken bones and $19 billion in costs annually, according to the foundation.

Many fractures result from falls, the leading cause of fatal and nonfatal injuries among older adults, according to the Centers for Disease Control and Prevention. The CDC recently reported that an estimated 27,000 older adults died in 2014 as a result of falling, while 2.8 million were treated in emergency departments. Furthermore, about 800,000 of these ER patients were later hospitalized.

Experts have become very concerned about trends that show an end to the 30-year decline in the incidence of hip fractures among older American women. This trend may be caused by, among other things, a reluctance to take bisphosphonates. Moreover, they fear the numbers are going to start rising again.

“We have a crisis, not only in this country but around the world,” says Douglas P. Kiel, a professor of medicine at Harvard Medical School and president of the American Society for Bone and Mineral Research. “We are not adequately treating osteoporosis.”

Between 2002 and 2012, the annual rate of hip fractures among American women older than 65 declined steadily, from 884 per 100,000 women to 740, according to research presented at the society’s annual meeting in September, Kiel says. “However, since 2012, the rate of decline has plateaued,” he adds.

In addition to fear of the drugs, there probably are additional explanations for the changes in reported fracture incidence. In 2007, for example, Medicare cut reimbursement for all office-based imaging services, including for DXA scans – tests that measure bone density – which may have discouraged doctors from offering them to women.

“In 2006, the national average for Medicare reimbursement of DXA scans was $139,” Kiel says. “Today, the national average is $42,” he says. “There has been a marked decrease in the number of physicians who provide the test in their office,” he adds. “The current Medicare reimbursement no longer covers a physician’s costs to perform the scan, which includes the technologist’s time to perform the scan and the doctor’s time to interpret the test.”

When women aren’t tested, they won’t know whether they have osteoporosis – which means they won’t receive treatment.

“We’re trying to get everyone – patients, doctors, insurance companies and the government – all on the same page making informed decisions,” Kiel says.

Kiel says that concerns about bisphosphonates are overblown.

“A very small percentage of patients on these drugs encounter side effects, and researchers are working hard to understand how we can minimize them further,” he says. “The data are clear that these drugs prevent enormous suffering and needless deaths.

“Both men and women with osteoporosis who have had an osteoporotic spine or hip fracture are at high risk for another fracture and should be treated with medications that can substantially lower their risk of future fracture,” he adds. “It’s shocking that so many patients don’t even realize that they are at risk for another fracture.”

Some of the medicines are inconvenient to take, requiring an empty stomach and sitting or standing upright for at least 30 minutes to prevent heartburn. However, there are other options, he says.
“There are oral drugs taken weekly or even monthly, and one that does not require an empty stomach,” Kiel says. “For those who do not want to take pills, there are twice-a-year injections or once-a-year IV [intravenous] infusions. They are all effective. People see their doctor annually, so it is not inconvenient to get treated annually and then not have to take pills and get refills.”

Recently, Kiels’s society and 34 other health and medical organizations around the world called on providers, governments, insurers and others in the health-care system to ease access to screening and therapies for high-risk individuals and to increase research and education to ensure that hip-fracture rates do not increase.

“My mother died of a hip fracture that cut her life short by many years,” Kiel says. “Up to 25 percent of hip-fracture patients die within one year of that injury. Some women have said that they would rather be dead than have a hip fracture and end up disabled or in a nursing home for the rest of their lives. We can prevent both with proper screening, diagnosis and treatment of osteoporosis.”


Why Do Autoimmune Diseases Affect Women More Often Than Men

Why Do Autoimmune Diseases Affect Women More Often Than Men

My sister-in-law, Donna Cimons, 77, a retired nurse anesthetist who lives on a farm near Cambridge, Ohio, began losing her hair as a teenager. She woke up each morning to find tufts of hair scattered across her pillow. By age 50, she was bald. She knew this problem ran in her family – her mother had it, too – but not much else.

“It had a name, alopecia areata, but that was all,” she says, speaking of the scant knowledge 60 or more years ago. “We really didn’t know what it was.”

Today we know that it is one of more than 80 autoimmune diseases that can be life-altering, even life-threatening. These occur when the immune system goes awry and mistakenly attacks healthy parts of the body rather than infectious invaders such as bacteria and viruses. It’s often described as the body’s inability to distinguish “self” from “non-self.”

Autoimmune diseases afflict 23.5 million Americans, according to the Department of Health and Human Services, although the American Autoimmune Related Diseases Association estimates the number at more than twice that.

These disorders disproportionately strike women – who account for nearly 80 percent of all cases – for reasons not well understood. Most often, they hit women in their reproductive years, often complicating pregnancy.

“Autoimmune diseases carry a huge burden for affected individuals and their families because of their devastating and chronic nature,” says Daniel Rotrosen, director of the division of allergy, immunology and transplantation at the National Institute of Allergy and Infectious Diseases. “They can require a lifetime of treatment, often with potent immunosuppressive medications that can have worrisome side effects,” such as raising the risk of osteoporosis.

The immune system produces a type of B cell that secretes autoantibodies. These substances can bind to the body’s cells and tissues. In people with healthy immune systems, several mechanisms keep these B cells in check and purge them from the body. However, the process can malfunction. When this happens, these B cells proliferate, producing autoantibodies that go on the attack – and an autoimmune disease results.

Autoantibodies can damage joints, the digestive system, the heart, lungs, kidneys and other organs, the nerves, hair follicles and the connective tissue in the skin and blood vessels. Although each disorder is distinct, they frequently share such symptoms as fatigue, dizziness and low-grade fever. Inflammation is a hallmark of all of them, both at the target site, such as the joints, as well as in the blood.

Among the more common autoimmune diseases are rheumatoid arthritis, which attacks the lining of the joints; Type 1 diabetes, which destroys cells needed to make blood-sugar-controlling insulin; multiple sclerosis, which damages linings around the nerves, affecting the brain and spinal cord; Crohn’s disease and irritable bowel syndrome, which harm the gastrointestinal tract; scleroderma, which causes abnormal growth of connective tissue in the skin and blood vessels; psoriasis, in which new skin cells rise up too fast, resulting in thick red patches and scales; Hashimoto’s disease, which attacks the thyroid gland; and systemic lupus erythematosus, often just called lupus, which can hurt the joints, skin, heart, lungs and kidneys. Lupus is especially prevalent in African American women, who are two to three times as likely to develop it as are Caucasians.

Many of these diseases can be debilitating.

“If you tell your friends and teachers that you have cancer, they understand it, but if you tell them you have lupus, they don’t understand that it took you three hours to get out of bed because your joints were so sore and inflamed,” says Judith James, chair of the Oklahoma Medical Research Foundation. “Lupus can also affect your brain and cause depression, and affect your ability to think. It’s a terrible disease.”

Sarah Feinberg, 42, of Silver Spring, Md., a planner at the U.S. Holocaust Memorial Museum, has lived with Crohn’s disease for nine years, although it wasn’t clear what was wrong with her when she began having symptoms at age 33.

Crohn’s, an inflammatory bowel disorder, also can affect the eyes, skin and joints – which is what happened to Feinberg initially. Her first symptom was an inflammation in the iris of one eye, followed by a painful rash under the skin, then temporary arthritis in her hips, knees and ankles.

“Then my stomach kicked in, and I started having to go to the bathroom eight, 10, 12 times a day,” she says. “Anything I ate went right through me. I was constantly excusing myself from meetings and going to the bathroom. I also couldn’t walk because of the arthritis, so I was hobbling to the bathroom.”
Finally, she underwent a colonoscopy – “which you don’t do for an eye problem,” she says – and was diagnosed with Crohn’s. She’s lucky, however. Her disease is mild and responds well to medication.

Researchers believe that gene mutations, the environment and even the human microbiome are involved in autoimmune diseases, citing such environmental stimuli as smoking, obesity, sun exposure and infection with the Epstein-Barr virus. These diseases often run in families and, while rare, some people can suffer from more than one at the same time, known as polyautoimmunity.

While my sister-in-law’s mother had alopecia, her daughter – my niece – developed a different autoimmune disorder, Hashimoto’s disease, when she was 10.

“Autoimmune diseases appear to be a mismatch between genes and the environment,” says David Hafler, chairman of the department of neurology at the Yale School of Medicine. “It’s not one gene; there are hundreds of common genetic variants which together lead to disease. But all this also raises the question of why we have not found the smoking gun that defines the gender risk.”

Women typically mount a more vigorous immune response than men to infections and vaccinations, producing higher levels of antibodies. In the case of autoimmune disorders, this trait seems to backfire. “Robust immunity in females can be good evolutionarily, but too much immunity can be bad if directed toward self,” says Rhonda Voskuhl, a professor of neurology at UCLA who studies multiple sclerosis.

Scientists believe that sex hormones also may play a role, because many autoimmune disorders occur in women soon after puberty. Some studies, in fact, suggest that the female hormones estrogen and prolactin stimulate the growth of B cell autoantibodies.

Scientists also think that sex chromosomes, specifically the X chromosome, may have an influence. (Everyone normally has one pair of sex chromosomes in each cell; women have two X chromosomes, while men have one X and one Y chromosome.)

The symptoms of some autoimmune diseases, including lupus, often worsen during pregnancy, while in others, such as rheumatoid arthritis, they may improve. “We’re trying to figure out why [these] two diseases with a lot of similarities [in symptoms] behave differently during pregnancy,” says Eliza Chakravarty, a rheumatologist at the Oklahoma Medical Research Foundation. “It’s not uncommon for women to have their first episode of lupus during pregnancy. It probably would have developed anyway, but it tends to come on during pregnancy.”

The relationship between autoimmune diseases and menopause is even murkier. “It used to be said that some of these diseases burn out with time,” says Betty Diamond, director of the Center for Autoimmune and Musculoskeletal Diseases at the Feinstein Institute for Medical Research in Manhasset, N.Y. “If you manage to have the kind of autoimmune disease that doesn’t kill you, it may smolder a little less by then.

On the other hand, there is a certain incidence of women who get an autoimmune disease after menopause, which tells you the whole problem is not hormones.”
Interestingly, men who develop these diseases often experience worse symptoms than women, probably because they lack “whatever factors protect [most] men or make it easier for women to get these diseases,” Hafler says.

These are chronic diseases; there are no cures, only medications to treat the symptoms, some of them with serious side effects.But the drugs are getting better. More than 300 medicines for autoimmune diseases are in the research pipeline.
Nothing, however, has helped my sister-in-law restore her hair. “I’m resigned to it,” she says. “I kept hoping something would happen, that they would make some kind of discovery that would get my hair back, but they didn’t.”
She copes. She owns three wigs, each of a different length. “Real hair grows, so I pretend,” she says. “I wear the short one for a while, then the medium one and then the longer one. And then I get a ‘haircut’ and start all over again.”
She knows things could be worse. While alopecia has drastically affected her appearance, it won’t kill her. “I know I’m not going to die from this disease,” she says. “But it would be nice to have hair.”



Here’s Why You Need Vitamin B12, And Where You Can Find It

Here's Why You Need Vitamin B12, And Where You Can Find ItWhat happens if you don’t get enough vitamin B12?

“Vitamin B12 deficiency causes tiredness, weakness, constipation, loss of appetite, weight loss, and megaloblastic anemia,” the National Institutes of Health says. “Nerve problems, such as numbness and tingling in the hands and feet, can also occur.

Other symptoms of vitamin B12 deficiency include problems with balance, depression, confusion, dementia, poor memory, and soreness of the mouth or tongue.” A paper published this summer theorized that Mary Todd Lincoln’s well-known psychological and emotional problems were caused by a shortage of the vitamin.

Okay, so you see it’s important. About 15 percent of Americans don’t get enough of it – and “a B12 deficiency can go undiagnosed for years,” J.J. Virgin writes in Prevention magazine. Symptoms such as fatigue, shortness of breath and forgetfulness might point to such a deficiency and should not be ignored.

Certain people are more likely to be deficient in B12, Virgin writes:

– Vegetarians and vegans. B12 is found naturally only in animal products (most notably beef liver and clams, NIH notes). “In fact, that’s a big part of how the ‘pale, weak vegan’ stereotype came to be: chronic B12 deficiency causes pale skin and weakness,” Virgin writes.

– People older than 50. You are more likely to have a deficiency as you age – and symptoms such as memory loss are easier to overlook when everybody attributes them to “senior moments.”

– People who drink alcohol regularly. The problem is, B12 is stored in your liver, and that is stressed by too much alcohol.

– People with acid reflux. As if heartburn weren’t bad enough, both stomach problems and the medications used to treat them prevent your body from absorbing B12.

– People with diabetes or an autoimmune disease. Again, these conditions prevent your body from absorbing the vitamin.

Fortunately, as Virgin notes, B12 supplements are easily available, by shots, lozenges and additives in food. Fortified breakfast cereals, in particular, are a good source readily available to vegetarians and vegans. And you don’t have to worry about overdoing it, because B12 is water-soluble – so your body takes what it needs and flushes out the rest.