#EBOLA and Mind Body #Health in the US

ebola-virus-close-up

With CNN blasting “RED ALERT” headlines and updates of the Ebola crisis all day long, it is not surprising that many people are developing a good dose of fear of a wide spread ebola outbreak here in the US. Admittedly, I myself awoke with an Ebola nightmare at 2 AM this morning with heart pounding. And in some ways, it is understandable. The thought of getting infected with a virulent virus that pierces your cells, hijacks your RNA equipment and kills senselessly and suddenly in a very dramatic way is downright scary.  However,in our country at this point in time, the fear is largely unfounded for the general public. The news alerts are sending your amygdala into a frenzy and it is time to serve yourself a healthy dose of cold hard cognitive FACTS.

1. Ebola Virus is not transmitted through the air, like with coughing or sneezing, meaning it is only transmissible when in very close contact with bodily fluids and only after symptoms (especially fever) are present. In other words, you are much more likely to be infected and affected by the usual suspects like flu, GI bugs, and the common cold while riding the subway to work or boarding a domestic airplane.

2. In countries where infrastructure and education are good, the virus has been contained even when there was some local spread, as in the case of Nigeria. This article by the NY times does a very nice job of illustrating the current status of Ebola and where it has spread inside and outside of the US. The countries with the highest number of cases have very limited infrastructure and literacy rates under 45% as compared to the US’ 99%. This means that myths about doctors or healthcare workers spreading the disease can flourish and it is very hard to get good information to people on how they can prevent contracting the disease for themselves allowing the disease to spread further.

3. But why did we have transmissions in the US then? The transmissions that happened in the US happened are thought to be due to a breach of protocols to a hospital that was ill prepared for Ebola and much has been learned since then how to prevent this from happening again. Indeed, the CDC is beefing up its efforts related to preparedness for treatment of Ebola will be sending out SWAT Teams to be sure that what happened in Dallas does not happen again in the US. “Meet the CDC SWAT Team”

So now that your fear is cognitively controlled, what do you do to further your mind body health. The answer is COMPASSION. There can be no lack of compassion that the affected people and families are experiencing. Here is a guided loving kindness meditation narrated by Buddhist Sharon Salzberg:

Feeling compassionate? Don’t just feel it, do something about it. Remember, studies show that giving makes us happier. And in this case, given that you become involved in the fight against Ebola when you help fund organizations fighting it, it might just help you feel more empowered too. Donate in tribute to someone else and you will get a double bang for your buck when it comes to happiness.  There are many aid organizations working hard to combat the Ebola Crisis. Here are some links to the ones that are very reputable and active at this time:

MSFDoctors Without Borders

red crossRed Cross

cdc foundationCDC Foundation 

Alice G. Walton has published an extensive article on aid organization for Forbes.com if you want to delve into the details a bit more before donating.

© Regina Zopf MD 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Regina Zopf MD with appropriate and specific direction to the original content. Accessing this site means you agree to the disclaimer that can be read here.

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5 Reasons to Love Tea More than Coffee

1.  Caffeine + L-theanine– It is well known that Black, Green and White Teas have caffeine for that quick boost that some of us crave in the morning, but it is less well known that tea also provides L-theanine. According to a study published in the Journal of Nutrition, L-theanine crosses the blood brain barrier and increases the amount of alpha waves in the brain. The overall effect of caffeine+L-theanine results in improved cognition. Think of it as a relaxed, but alert state. Sounds pretty ideal, doesn’t it? Switching to tea is great for folks who need to cut back on caffeine intake but don’t want the withdrawal repercussions, such as pregnant women, because some caffeine is still provided, but not at the levels found in coffee.

ltheanine        caffine

2. Tea is “GREEN”. With a smaller “water footprint”, Tea uses 1/10th the water as coffee to produce per cup. I’m not talking about the water used just to make the cup in your home or favorite coffee shop, but rather the water used to grow and produce the coffee. The amount of water used to create one 125 mL cup of coffee is actually 1,120 Liters. The amount used for tea? only 120 Liters. Check out this bar graph from the Economist that compares the water used for producing everyday products like coffee, tea….and beer!

coffee tea water cost

3. Healing benefits of herbal teas. Not only are they tasty, they are a nearly zero calorie way to rejuvenate. Pop on by a local tea shop near you and I am sure you will be able to find a tasty blend that serves itself up as a guilt free indulgence. Some of these teas can even have healing benefits depending on what ails you. For example, chamomile has long served as a calming tea that can aid in digestion. I love Mind & Body Tea from our local tea shop here in DC called Teaism.

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4.  Easy to grow your own. If you tried to grow a coffee tree in your backyard, you would probably not be very successful. Tea on the other hand can be grown quite easily as an attractive potted plant on your patio that you bring in for the winter (if you live in a cold climate). Growing your own tea not only decreases your carbon footprint related to caffeine consumption, it also gives you the benefits of having green plants around your home, and offers air cleaning benefits in your home. We had our tea plant shipped to us from the Camelia Forest Nursery.

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5. It’s beautiful -The ritual of tea spans histories. Full ceramics and spice trades have been based on the plant. But I’m not even talking about that. Simply taking the time out of your day, boiling water and pouring the water over your favorite tea to steep, and then seeing, hearing the water hit your cup, as you pick it up to feel the warmth in your palms, and the aromatic steam is inhaled through your nose as you instinctively draw a long soft warm breath. Even if only for a few minutes, you are able to live in mindful splendor and fully embrace the beauty in the moment. In this way, the drinking of tea, before you even ingest it, is healing you and building your resilience in the simplest of ways.

© Regina Zopf MD 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Regina Zopf MD with appropriate and specific direction to the original content. Accessing this site means you agree to the disclaimer that can be read here.

Family Planning, Biofilms and Conservation

multiple-babies

Time and again it has been shown that women limit the size of their families in societies that sustain improved health, education and socio-economic vitality. Limiting family sizes is key to humanity reaching a sustainable population level and limiting human impact on the natural environment. Historically many women have turned to “the pill” for limiting of family sizes. More recently however, according to the Guttmacher Institute, there tends to be a trend in the increasing use of IUD among young women. Myself and my OB/Gyn colleagues are also seeing this trend in our own practices. They are drawn to the overall low cost, convenience of the method as well as the effectiveness. Still other women prefer to avoid the side effects that come along with birth control pills, like decreased libido, vaginal dryness and pain with sex, or breakthrough bleeding.

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When it comes to the Copper IUD, otherwise know as the “Copper T” by Paragard, there is the silver lining related to the environmental effects. The birth controls women take on a daily basis can be excreted into waste water and make their way into the local environments we live in contaminating our water. Studies have shown downstream rocks to be covered in a type of “biofilm” that contains these waste products. So using a copper IUD can actually reduce these waste products from entering our environment to being with.

Copper IUDs are a form of long-acting reversible contraceptives or LARC’s which are recommended by ACOG for prevention of unplanned pregnancy in teens. They are also a form of emergency contraception which can be used with great effectiveness up to 5 days after the unprotected pregnancy encounter.

While IUDs can be an effective and convenient way to control family size, it should be noted that in women delaying childbearing past the age of 30, are at an increased risk for ovarian cancer and birth control pills that are used for 5 consecutive years or more reduces this risk by 50%. This is especially true for ovulation that occurs in the 20s. Therefore, women in their twenties may find the cost-benefit ratio to weigh towards pill use in their 20s switching over to the IUD for the remainder of their family planning years. Also, women that suffer from heavy irregular and/or painful periods may need the pill or a hormone containing IUD to help control their symptoms and to prevent endometrial cancer. Additionally the IUD may be uncomfortable to have placed and does have some risk during or after placement. You can read more about the method here.

Regardless of what my opinions are they are not a medical opinion for individuals and women should always discuss what the right birth control method is for themselves with their own personal physician.  For those who do find the Copper T to be the right method for them, they can rest assured knowing that they are doing a little something for conservation of the environment and our water supply.

It should be noted that I have no financial arrangement with Paragard and I have not been paid for this posting.© Regina Zopf MD 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Regina Zopf MD with appropriate and specific direction to the original content. Accessing this site means you agree to the disclaimer that can be read here.

EWG’s Mercury Calculator: Omega 3s for Women’s Health

EWG

Environmental Working Group has released a mercury calculator that can tailor how much fish you should be eating for adequate Omega 3 Fatty Acids and how much you can eat safely to avoid toxic Mercury exposure. This is especially great for pregnant women and breastfeeding moms (as you can read about in my previous post) however for optimum health, all women need Omega 3 fatty acids.

If you haven’t already heard, Omega 3 fatty acids are essential fatty acids for good health and for decreasing inflammation. Women that have health problems that are caused by or worsened by inflammation should all ensure they are getting enough Omega 3 fatty acids. Inflammatory conditions are many, but some common ones that affect women include, menorrhagia (heavy bleeding), dysmenorrhea (painful menstrual cycles), fibromyalgia, thyroid disorders, arthritis and more.

The balance in the standard American diet of Omega 3 to Omega 6 is abysmally low which has been associated with heart disease, inflammatory diseases and more. As with many vitamins, it is much more effective when the Omega 3’s are obtained from whole food sources. Find a complete grocery list of foods containing omega 3’s here from Web MD. The EWG calculator is also nice however because it also gives some limited information about which sources are sustainable. For more detail on specific fish and sustainability based on where they are harvested, keep in mind the best source is seafoodwatch.org of the Monterrey Bay Aquarium.

© Regina Zopf MD 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Regina Zopf MD with appropriate and specific direction to the original content. Accessing this site means you agree to the disclaimer that can be read here.

Support @EWG’s creation of a new food database and get tips on avoiding chemicals in pregnancy

As a gynecologist, I really value the service that the Environmental Working Group provides for me and my patients. Several years back, they even worked directly with me to create a patient information sheet with how women can reduce their exposure risk to harmful chemicals when women are pregnant, breastfeeding, or trying to conceive. With diseases like Autism Spectrum Disorder and Cancer on the rise, and a poorly regulated chemical industry where harm must be shown before a chemical is taken out of public use, the importance of the work they do cannot be overstated to a public that is often left finding ways to protect itself. In situations like these, grassroots is the only way. This is why I am voluntarily supporting them without their solicitation and hope you will too. They have a great database called Skindeep where you can check out the health risks of the beauty products you use everyday. They also have databases on keeping a healthy home, healthy cleaning products and and sunscreen guide. Having a food database will be that much better for those of us want to know what we are putting into our bodies. After all, you are what you eat.

You can check out their website at EWG.org

Or donate $10 here to support the completion of the database:
https://donate.ewg.org/p/salsa/donation/common/public/?donate_page_KEY=7631&track=201409FDB3NG&utm_source=201409FDB3NG&utm_medium=email&utm_content=first-link&utm_campaign=fund

Here is the patient information they gave me for protecting my pregnant patients as well if you want to use it for yourself or your patients:

The Environmental Working Group

Tips to Reduce Chemical Exposure in Pregnancy

Pollutants in a pregnant woman’s food, air, water or consumer products
can cross the placenta from her body to her child at the most vulnerable time of life. Follow these tips to reduce exposure to harmful chemicals.

Eat Right

Fruits and veggies – Eat plenty of fresh fruits and vegetables. Buy organic when you can to reduce your pesticide consumption. Check out EWG’s Shopper’s Guide to Pesticides in Produce, especially the Dirty Dozen list of high-pesticide fruits and vegetables. http://www.ewg.org/foodnews/

Meat and dairy – Eat low-fat dairy, lean meat, and meatless protein-rich foods to reduce exposures to pollutants that build up in animal fat. Choose brands without added antibiotics and growth hormones when possible.

Ditch the can – Choose fresh food over canned, packaged and processed food to avoid bisphenol A, a synthetic estrogen, and other artificial additives and package coatings that can leach into food. Read labels to find foods with natural ingredients and lower sugar, sodium and trans fats.

Safe seafood – Choose low-mercury fish such as salmon, tilapia and pollock, rather than higher-mercury tuna and swordfish. Mercury is a potent neurotoxin that can damage the developing brain and nervous system.

Iodine – Use iodized salt for home cooking. It counters perchlorate and other chemicals that can disrupt the thyroid’s growth hormones critical to a baby’s development.

Storing and cooking – Store food in glass containers. Don’t microwave in plastic, since plastics additives can migrate into your food.
Drink plenty of SAFE water
What’s in your water – Get your water quality report from EWG.org or your local utility. Test your water for lead.
The District of Columbia and Maryland have some of the highest levels of trihalomethanes in the country. This has been linked to miscarriages and birth defects – such as low birth weight, small body length, small head circumference and neural tube defects. This can be removed by using a carbon filter or by boiling your water.
Filtered tap water – Skip bottled water, which costs more and isn’t necessarily better. Filter your tap water instead.

Filter choices – Choose a filter that’s certified to take out your water’s pollutants. Carbon filters are affordable and remove lead and toxic chemicals created by treatment processes at municipal water utilities. Reverse osmosis filters cost more but take out substances that carbon can’t, like arsenic, chromium and perchlorate.

Reuseable Containers – Drink from stainless steel or BPA-free plastic containers when you’re on the go, and check out EWG’s Safe Drinking Water Guide for more tips. http://www.ewg.org/BottledWater/Bottled-Water-Quality-Investigation/Safe-Drinking-Water-Guide

Choose Better Products, Avoid Chemical Heavy Chores

Cosmetics – Cut out non-essential personal care products. Choose fragrance-free productswith the fewest ingredients possible. Find safer products in EWG’s Skin Deep Cosmetics Database. http://www.ewg.org/skindeep/

Clothing – Wash maternity clothes before wearing. Clothing is often coated in the factory with chemical treatments.

Green cleaning – Leave shoes at the door to avoid tracking dirt and dust-bound pollutants into your house. Clean with fragrance-free brands. Don’t use unneeded, harsh and caustic products, such as bleach discs for toilet bowls, air fresheners (open a window instead), harsh oven cleaner (use baking soda) or drain cleaners (use a drain snake). Use a wet mop and a HEPA-filter vacuum cleaner to avoid breathing in dust.

remodeling – Avoid remodeling if your house was built before 1978, when lead house paint was banned. Dust from sanding old paint is a common source of lead exposure. If others do the work, make sure they wet-sand chipped areas.

Pumping gas – Don’t breathe gasoline fumes. Ask your partner to fill the gas tank, or use full service.

For more information visit:

http://www.pregnancyawareness.com

http://www.ewg.org

A gynecologist’s favorite gut bug and probiotic: Lactobacillus rhamnosus

I’ve said it! My favorite bug is L. rhamnosus. I know it sounds crazy, but just looking at the image of them makes me happy. WHY?!

l rhamnosus

If you haven’t heard the news the bugs, or microbes, that colonize our bodies are amazing. There are over 10,000 strains of these microorganisms that make up almost 5 lbs of our body weight. More and more data continues to emerge related to the bugs that inhabit our bodies and the amazing health benefits they provide, not just for the body, but as it turns out, for the mind as well.  We each have our own unique “fingerprint” of these bugs that is likely determined by our mothers vagina, but also, can be influenced by our own diet and lifestyle, and in some cases by taking probiotics. So why do I have a favorite?

For many gynecologists and the women they care for, recurrent BV is a pain in the neck to treat. This is why early in my career, I began to do some research to see how I could better serve my patients. When it comes to recurrent BV, I have had many patients benefit from the simple addition of the strain of Lactobacillus rhamnosus. It turns out that a healthy vaginal flora provides a microenvironment that is not very pleasant for nasty bacteria that can cause a yucky fishy odor and a thin vaginal discharge. This study, published in the journal of Immunology and Medical Microbiology showed that in a randomized, controlled trial, oral L. rhamnosus not only colonized the vagina, it also prevented BV and candida colonization of the vagina. Many of my patients that were coming back to me for recurrent BV swear by this probiotic. Some are even able to treat themselves without the help of antibiotics by taking it when they start to feel some discomfort or discharge.

But wait…there’s another reason why I like this bug for women and it involves weight loss. A large study showed that babies that are delivered by cesarean section and or are formula fed suffer higher rates of adult obesity. It is thought to be due to the lack of healthy flora that babies born through the vagina get. Recently after noticing my own weight gain following treatment with broad spectrum antibiotics, I remembered the studies about obesity and cesarean section. I decided to look into which strains might be beneficial for weight loss. And I found this study. They randomly gave L. rhamnosus or a placebo pill to men and women that were attempting to lose weight with the exact same diet and exercise regimen. They found that the women dieters (BUT NOT THE MEN!!!) using the L. rhamnosus lost twice as much weight as those taking the fake pill. Keep in mind, the study was funded by Nestle so potential bias could exist however the double blind design does minimize potential bias. Keep in mind…you still have to exercise and eat right!!! But the addition of the probiotic should give you an extra boost. It worked for me!

Still more and perhaps most interesting, there was a neurobiology study looking at depression behaviors in in mice taking L. rhamnosus versus not taking it. What they found was that mice that were given the L. rhamnosus (JB-1) strain had significantly lower levels of the stress-induced hormone corticosterone and exhibited less anxiety- and depression-related behavior. It was thought to be driven by the vagus nerve and effects of GABA receptor expression. So how’s that for mind-body. Perhaps we should really be talking about mind-body-bug.

Hopefully this will convince you that your own microbiome can protect you and explains why as a gynecologist, L. rhamnosus is my favorite bug. Here are some natural ways you can promote your body’s own beneficial flora:

Diet high in fiber

Sleep

Exercise

Plant based diet

So there you have it, the reasons why my favorite gut bug is L.rhamnosus.

For more on the microbiome, check out this TEDx Talk on YouTube.

Or this talk by Stanford Immunology Professor David Relman

If you want to try a supplement, here are some products that have the L. rhamnosus strain, but there are many out there that will work, you just have to look for it on the side of the probiotic bottle where they have the strains listed. Try to buy from a reputable company however so you can ensure you are getting active strains.

© Regina Zopf MD 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Regina Zopf MD with appropriate and specific direction to the original content. Accessing this site means you agree to the disclaimer that can be read here.

Green Health for a Green Planet: My favorite ways to go green through healthy living

Here are simple ways we can save our planet while promoting our own vitality and longevity. Taking these steps for better health will also contribute to conservation of nature on our beautiful planet.

veggies

#1 Go Vegan:  Nutrition is one of the optimum ways we can save the planet while improving our health.  As a physician, the most interesting field for me to see evolve is the field of nutrition. Once thought to have no bearing on health by the field of medicine, doctors now agree that a healthy diet is one of the most important things you can do for promoting health and wellness. The healthiest diet for prevention of chronic disease and for longevity is a vegan diet and the silver lining is that it is also beneficial for the planet. Eating lower on the food chain leads to more efficient energy use, greater diversity of plants and animals, and reduced pollution of our water from nitrogenous animal waste. In addition, a plant based diet provides us with the whole foods and nutrient balance that our bodies have evolved to thrive on. Ecosystems benefit from diversity, and as it turns out, so does the ecosystem of bacteria that exists in your own body so be sure to eat a diet rich and varied in whole grains, fruits and vegetables. To learn more, check out the documentary Forks over Knives, or pick up the new book on making the transition to a plant based diet. Want to do one better? Go organic! Check out the dirty dozen list from the Environmental Working Group to find out which organic fruits will give you the best bang for your buck related to pesticide reduction. Have access to a community garden? SAVE THE BEES and GROW YOUR OWN VEGGIES! Sign the petition to promote vegetable gardens everywhere.

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#2 Get into Nature: The benefits of getting into nature are far reaching. For one, you are likely to be exercising which is the other most important thing doctors recommend you do for your health. Live in a city? no problem, hit the park, green space of any kind will still give you the benefits. If you have access to a community garden, you’re loving it, not only are you benefitting from digging in the soil, you will also be providing food for dying bee and butterfly populations as well as improving the nutrient content of your vegetables. Heart rate variability, which is an indicator of heart health and balance of the parasympathetic and sympthetic nervous systems, increases when you are in nature. Preliminary studies have shown that “earthing”, basically walking barefoot on dirt, leads to positive physiologic changes. (Just watch out if you live in an area with pin worms).  Hate bugs? …try a lemon eucalyptus based bug spray, recommended by the CDC to prevent tick and mosquito borne disease, and don’t forget the sunscreen! Check out the free database on Skindeep.org for non-toxic sunscreen options. Want to become more involved in conservation itself? Check out The Nature Conservancy volunteer activities in your area.

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#3 Mindful Awareness and Meditation: Living mindfully allows us to separate from habitual thinking and behaviors. All too often we function on autopilot, allowing automatic behaviors and primal feelings to drive our actions and behaviors.  Being mindful, living true to our core values and making conscious choices about how we spend our money, our time and our energy can help us to make important health changes like the ones I mention here. It can also make us more compassionate which is probably the most important value to have in our work protecting the planet. If you haven’t jumped on the meditation band wagon yet, or still think it is not something you are capable of in our non-stop stimulating culture, it might be easier than you think.  I recommend the Jon Kabat Zinn book Full Catastrophe Living or one of his youtube videos as an introduction to mindfulness and meditation. You can also check out free guided meditations from UCLA’s Semel Institute.

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#4: Bike! As much and as often as possible. If you follow this blog you have seen the “carternative” my husband has created to cart us around town. This contraption has improved our quality of life ENORMOUSLY. We don’t have to look for parking, we save on gas and parking tickets, and we usually get where we are going faster, or as fast as in a car. This is especially true for urban environments. Any time you bike instead of turning on your car, you are reducing carbon emissions, not to mention reducing oil consumption while exercising your body and calming your mind. Don’t want to arrive at work all sweaty? Consider an electric assist on your bike. Check out this blog that covers bikes as transportation as well.

#5: Shop Less: Excess consumption and a BUY BUY BUY culture contributes greatly to carbon emissions, global warming and landfill waste. Shopping less is healthy for your wallet as well as your mental health. A very interesting study published in the Chicago Journals by Rik Pieters found that materialism and shopping lead to loneliness which in turn led to more shopping.  Still believe in retail therapy?  Try consignment stores and thrift shops instead. They are a great way to reduce waste while benefiting others, find a Goodwill or Salvation Army near you. Studies show that giving to others can makes you happier, particularly if you give directly to someone you know so there is added incentive to simplifying and cleaning out those closets.  Having willpower difficulties in curbing that shopping habit? Try the book Willpower Instinct here to learn more about how you can curb cravings and increase your willpower.

If you are interested in implementing some of the changes I mention here, remember, persistence AND positivity pay off! Take time to observe how you can be successful at making the changes and always prepare for what could go wrong and sabotage your success ahead of time. Finally, be sure to focus on the rewards, there are plenty of silver linings with these changes.

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GREEN HEALTH=GREEN PLANET!!!


© Regina Zopf MD 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Regina Zopf MD with appropriate and specific direction to the original content. Accessing this site means you agree to the disclaimer that can be read here.