It seems like the more medicine seeks to try and make strict recommendations on what good screening policies to follow, the more confusing it gets. This time questions are being raised about the efficacy of mammograms.

Conventional wisdom had taught us that the best approach is for women to have a screening mammogram every year after 40. Now, we hear that maybe that approach needs to be changed or at the very least revisited.

A recent study published in the British Medical Journal indicates that there is no decrease in deaths from breast cancer as a result of yearly mammograms.

As you might imagine, that has really caused quite a bit of concern and confusion.

The study was started in 1980 and followed almost 80,000 women in Canada divided into 2 relatively equal groups.  One group got the physical exam and mammograms, and the other received just the physical. The sheer numbers of patients in this study make it impossible to ignore. The question becomes though, What does the data that they have really mean?  Is there a difference between 1980’s mammography and the digital mammograms of today?

The researchers in Canada drew the following conclusions:   “Our data show that annual mammography does not result in a reduction in breast cancer specific mortality for women aged 40-59 beyond that of physical examination alone or usual care in the community. The data suggest that the value of mammography screening should be reassessed.”

Wow….that does seem to turn our routine procedures on its head…but not so fast.

As with many of these studies, it is important to really evaluate what we are being told. If we dig a little deeper into the report, we also see that in the group without the mammograms, those who ended up with breast cancer, had larger tumors (2.1 cm v 1.4 cm) and that the cancer was more likely to have spread into their lymph nodes (34.7% v 16.5%).

In addition to that, the women with larger tumors had a lower the survival rate. The study authors themselves state: “The 25 year survival was 77.1% for women with tumours of less than 2 cm, compared with 54.7% for tumours greater than 2 cm (hazard ratio 0.46, 95% confidence interval 0.37 to 0.58; P<0.001). “

The American College of Obstetricians and Gynecologists maintains its recommendation that mammography screening be offered annually to women beginning at age 40. They also state that there have been eight other randomized controlled trials that have shown mammograms do help prevent deaths for women in their 40s and 50s. In addition, data from numerous and much more recent observational trials have been published confirming a reduced mortality with modern mammography screening methods.

This is clearly a debate that has only just begun. The question for those of us in the trenches though, is what do we do now?

As we continue to get more and more information I would suggest that we all pay attention to any new data, but for now I would recommend sticking with the current recommendations for annual mammograms after age 40. Although there is always a risk of over diagnosis, from what we know today, it seems like sticking to the status quo of yearly mammograms is the safest approach.

Happy 2014!

Another New Year and another fresh start!

The one thing I hear the most from patients is that they know what they need to do, they just can’t seem to get it done. I mean we all know that a diet of Big Macs and supersized Cokes probably isn’t the fastest path to weight loss…right?

We just have to take that first step in the right direction to achieving our goals for our weight and our health.

The hardest part of any diet…the absolutely hardest part…is the first day.

Taking the first step to weight loss success in 2014.Dr Martin Luther King once famously said “Take the first step in faith.   You don’t have to see the whole staircase, just take the first step.”

That absolutely applies to those New Year’s Eve resolutions.

If your goal is to lose 5, 10 or 50 pounds, you have to start with a single step. You have to think about holding the line on that first day and avoid those chips, Cheetos and doughnuts.

Contrary to what that little voice in your head keeps repeating…Most carbohydrates (meaning cookies, candy and pies) are NOT your friends.

Oh, I know…they look and smell so good and appear soo very friendly, but they do not have your best interests at heart.

There are so many options for how to improve your diet.

There is the all or none approach. That means just about completely removing anything from you diet that could in any way keep you from losing weight.

There are a couple of problems with that approach.

One is that it isn’t the healthiest idea if you try to do it for longer than a couple of weeks.

The other is that is darn near impossible to do it for long.

My guess is that you don’t want to just lose weight for a week, but that you want to maintain it for a lifetime.

The key is to start with a plan that you know you can reach and maybe have reached before.

You can start with dropping the amount of carbohydrates you eat to no more than 100 grams a day. You can also start by just being holding fast on the sugar and desserts.

If you want to lose 50 pounds, think about losing 5. If you want to lose 15 pounds, still think about losing 5.

Slow and steady are the winning phrases here.

Take the baby steps, get those little successes and before you know it, you will reach or surpass your goals.

I know we are always looking for that quick fix and the new gel reported in the news that keeps you from being hungry is tempting but it is still in its experimental stage.

As it says in the article “The use of gel alone is more than capable of providing prolonged satiety but leads to unpleasant sensations for the consumer if there is no delivery of energy to the body to compliment the sensation of satiety.”

And that never ends well.

Stick to the tried and true. Eat less and as we will explore next month..Move More!

I am very excited about blogging about healthy eating, weight management, menopause, bioidentical hormone replacement and just about anything else that sounds interesting.

If there is a topic you would like me to explore, just send me a note on the Habermehl Aesthetics and Wellness Center Facebook Page (and don’t forget to like the page while you are there☺)

Today we take a look at that old staple…the apple… and ask a question that I’m sure has been weighing on you for months, years…even decades.

Does an apple a day really keep the doctor away?

Does an apple a day keep the doctor away?

We all remember that saying when we were kids. An apple a day keeps the doctor away.

Now it’s time to take a look at that saying and ask ourselves…fact or fiction?

It seems like only yesterday when we were   bringing those shiny apples to school thinking it was not only potentially good for our grades, but also good for our teacher’s health.

The question is…Is an apple each and every day really good for you?

It turns out that a single red delicious apple has a grand total of 25 grams of carbohydrates and up to 95 calories. That is not an insignificant amount.

For those of us that may be working on losing weight and have a carbohydrate restriction, 25 grams of carbs may really eat into our daily allotment pretty quickly.

We should remember, though, that there are many positives about the mighty apple.

Apples contain many of the vitamins we need. They contain Vitamin B6, which helps your body create numerous neurotransmitters, chemicals that transmit signals from one nerve cell to another.

B6 also helps in the production of the hormones serotonin and norepinephrine, which impact on your mood, and melatonin, which helps synchronize your body’s biological clock.

According to the USDA, one medium-sized apple also provides 8.4 milligrams of Vitamin C.

Vitamin C, also known as ascorbic acid, helps to synthesize collagen, a component of tendons, ligaments, blood vessels, skin and cartilage. Vitamin C also helps repair and maintain bones and teeth and helps wounds to heal.

Vitamin B-1, thiamine, is also known as anti-stress vitamin because it powers up your immune system and improves your body’s ability to cope tense conditions.

Apples also contain Vitamin B-2 or riboflavin. Your body needs riboflavin for growth, production of red bloods cells and to convert folate and vitamin B-6 into usable forms.

Another positive feature of apples is the amount of antioxidants that they possess. The red delicious apple has the highest amount of antioxidants.

Antioxidants help you stay healthier by decreasing inflammation in your body. They have the power to protect you from disease and slow the aging process. They relieve what is known as oxidative stress, which occurs when free radicals attack your cells.

Oxidative stress can also lead to a decrease in your body’s immune system and an increase in susceptibility to certain medical conditions such a heart disease and diabetes.

In order to keep your body healthy and your immune systems strong, you must consume a fair amount of antioxidants.

So at the end of the day, although the apple does deliver 25 grams of carbohydrates, it also delivers vitamins and some of the antioxidant protection we need.  This means that there is a lot an apple can do for you, but especially if watching your carbs, maybe just not on a daily basis. You can also get vitamins and antioxidants from berries and of course from multivitamins and supplements like fish oil.

So the mighty apple? Eat up, but think about having 3-4 in a week instead of a daily staple.

http://ajcn.nutrition.org/content/81/1/215S.full

http://www.livestrong.com/article/267690-what-vitamins-do-apples-contain/