Living Well


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Women have special needs when it comes to their health. More than 30 percent of the population is overweight, and cardiovascular disease is still the number-one killer of women. The added stress of juggling all the aspects of modern-day life takes its toll in the form of a poor diet, lack of sleep and not enough exercise. San Diego’s women’s health experts get us back on track with the latest recommendations for a heathy, happy and long life.

Supplemental
All our experts agree that nothing is more effective than getting vitamins and minerals from food — and that any supplement should be considered a medication. Avoid megadoses and deficiencies by consulting with a physician to see what your exact needs are, which may or may not include a multivitamin, higher ­doses of vitamins D and B12 as you get older, and an omega-3 fatty acid supplement. These have been shown to improve cholesterol and blood pressure, decrease risk for cardiovascular disease and developing dementia, and potentially improve mood, skin and hair.

Drink Up!
Water: Most experts recommend a daily average of a liter or four to six 8-ounce ­glasses. Women who perspire a lot through running, hot yoga or high-intensity sports need to alternate between water and electrolyte drinks, because sodium levels can become dangerously low when drinking only water during such exercise. Those with blood pressure or kidney problems need to consult with their doctor about proper water intake due to water retention.
Alcohol: Though the “one glass of alcohol per day” rule has been extolled as good for heart health, there are exceptions, say our experts. Dr. Irma Covarrubias, family physician at Kaiser Permanente, says that rule still applies, but only if there are no risk factors. Also, anyone on medication should avoid alcohol due to possible increased problems with the liver. Dr. Anupam Garg, a Scripps OB/GYN, cites recent studies that show daily alcohol intake substantially increases the risk of breast cancer in women. “So the overall guideline of one drink a day is too aggressive for women due to breast cancer risk,” he warns.

Sleep It Off
No question: Sleep is important. The magic number hovers between seven and eight hours, with some needing a little less or a little more. Dr. Abbo emphasizes that women need restful sleep, meaning “achieving REM sleep and feeling well-rested upon waking.” Sleepiness during the day is usually a sign you haven’t gotten all of your rest at night, she says.

Work It Out
If you aren’t exercising regularly already, Dr. Garg suggests starting with a 20- to 30-minute walk during your lunch break or after work. “It’s a huge start and starts changing the metabolism right away.”
How much and how often? Minimum three days a week for 20-30 minutes, eventually working up to 60 minutes a day, six days a week. “This means 60 minutes of increased heart rate and sweating!” stresses Dr. Abbo.
What about strength training? A minimum of two days a week for 20 minutes, with a day’s break between, is the most recent recommendation. Because of loss of muscle mass each decade starting in a woman’s 30s, a corresponding increase in resistance (consult a personal trainer) is key to preserve all-important muscle and bone. As you get older, focus on balance and stretching, in addition to resistance training and cardio.

Don’t Stress
Stress and lifestyle are circular, says Dr. Garg. Though we may not be able to change the stressors themselves, there are steps to relieve stress that make the stressors seem, well, less stressful.
More exercise > Major stress reliever > Less worried about health > Less stressed about the rest of life > Better sleep > More energy = Better health and less stress!

Skin Is In
Tips for healthy and beautiful skin from medical estheticians Magdalena Weber and Sara Aguilar at Moradi, M.D.:
Wash the face morning and night with lukewarm water. Anything hotter can strip the skin, and hot water can stimulate rosacea or break capillaries. Cold water closes up the pores and makes it difficult for products to absorb. If you have oily skin, look for cleansers with ingredients such as salycylic or glycolic acid. For mature, dry skin, look for ingredients such as chamomile or green tea extract.
Four essentials to slow down aging (these can be used starting in a woman’s 20s): growth factors, vitamin C, retinol and peptides. Use the antioxidants in the morning and the retinol at night. If the retinol is too irritating to use every night, alternate with a calming hydrator.
Don’t make these common mistakes: not using the proper products; overexfoliation, which leads to irritation and overproduction of oil; not washing your face at night; and not being on a regular skin-care regimen.

Numbers to Know
Healthy cholesterol: Total should be less than 200, with HDLs greater than 40 and LDLs lower than 130.
Blood pressure: 120/80. Anything over that is considered pre-hypertension, a red flag for heart health.

Food Yays
• A wide variety of fruits and vegetables. “Try to get at least one fruit or vegetable in with each meal,” suggests Dr. Michelle Abbo, internist
at Scripps Memorial Hospital La Jolla.
• Legumes such as chick peas, lentils and beans
• Grains such as wild rice, barley and quinoa
• Lean white meat

Food Nays
• Red meat (eat seldom)
• Charred meat (the charring is carcinogenic)
• The white stuff: white
rice, white flour, white bread, pasta and sugar

Things to maintain natural sleep
• Regular exercise
• Not eating too closely to bedtime (stop at least two hours before)
•Avoiding stimulants like caffeine about eight hours before going to bed

What can consistent, restful sleep do?
• Regulates metabolism
• Improves memory
• Helps prevent dementia
• Assists in wound healing
• Bolsters immune system

Testing It Out
The latest recommendations on the tests a
woman needs, and when
20s
• General exam
• Breast exam
• Pap smear
• Possible blood pressure screening (if there’s a family history of high blood pressure)
• Thyroid test
30s
All of the above, plus
• Baseline blood tests
for cholesterol and
blood pressure
• Skin exam
40s
All of the above, plus
• Annual mammograms
50s
All of the above, plus
• First colonoscopy for colon cancer (then 5-10
years after that if the first
one is normal)
• Skin exam
60s
All of the above, plus
• Dexa scan for bone density scan to assess bone health and any
risk for osteoporosis
(10 years after menopause or
at 65, whichever comes first)

Exercise Benefits
• Decreased risk of death
• Improved blood sugar
• Improved blood pressure and cholesterol levels
• Less dementia and depression
• Better skin elasticity

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