Your Life! Magazine.com All rights reserved. Copyright 2004-2008 Your Life! Media
Mirabai Holland, MFA Health & Fitness Editor
Nieca Goldberg MD, is one the first doctors to bring out the word about the differences between heart disease in men and women. Her first book, Women Are Not Small Men-The Women's Healthy Heart Program: Lifesaving Strategies for Preventing and Healing Heart Disease was dedicated to the subject.
Her new book, Dr. Nieca Goldberg's Complete Guide to Women's Health is designed to answer the women's health questions that too often go unanswered.
Q:Dr Goldberg, you've just released a book entitled Dr. Nieca Goldberg's Complete Guide to Women's Health. You're a cardiologist; why did you feel it necessary to write a women's health book instead of just sticking to cardiology?
A: I published my first book which is a book on women and heart disease six years ago…..I devoted my practice to only caring for women. I found that women were coming into my office with all kinds of symptoms…..and women really wanted the answers to where their symptoms were coming from and what's normal and what's not.
A: For women in their thirties, that's when the risks for heart disease start to increase….. in fact the leading killer of women over the age of 35 is heart disease.
…..you start to gain weight, blood pressure starts to increase, and so does your cholesterol.
Q:So how do you lower the risk for heart disease?
A: What I like to do is to catch the woman before it's a problem and find out what she's doing for herself. It's physical activity, exercising at a moderate pace that means you're short of breath but you can still talk, for at least a half hour a day.
A good starting point is even ten minutes a day.
Q: A lot of women get frightened, they feel chest pain. How do you tell the difference between heartburn and a heart attack?
A: You should never make the diagnosis at home. But there are questions that the doctor will ask you. For instance, heart pain usually starts when you're active.
You might walk a couple of blocks, you feel this pressure in your chest, you stop and it goes away. And that's the time - you should call your doctor and get a check-up.
You don't want this to go on for weeks so that it wakes you up from your sleep and you're sweating and short of breath and that's when you're having a heart attack.
Heartburn pain usually happens after a meal…..sometimes the taste of acid in your mouth. ……when the acid backs up it can irritate the throat and you might even cough.
Q: There's a lot of talk about taking aspirin every day. What do you think about that?
A: There's a lot of confusing information about that. Even though studies have shown that a baby aspirin a day lowers heart attack risk in men over the age of 45, the research in women is a little different. And this is the bottom line on the research. Aspirin reduces the risk of a second heart attack in women with heart disease of any age it reduces the risk of first heart attack we call that primary prevention in women over the age of 65, And in younger women it reduces the risk of a first stroke caused by a blood clot. So I not only want women to find out whether they're at risk for a heart attack but also stroke.
If you're doing everything right and you're say a healthy 35 year old woman never had heart disease and no risk factors for heart disease, then an aspirin doesn't add to lower your risk.
Q:Let's talk a little about hormones and those changes that come with age.
A: One of the options for women who have menopausal symptoms is hormone therapy and there are many formulations. For instance if it's vaginal dryness that seems to be the major problem you can use local therapy.
Taking hormone therapy obviously has been very scary for the last six years
And that's because of the Women's Health Initiative where synthetic hormones were given to women who were about twelve years into menopause. And even though those hormones are the best method of taking care of menopausal symptoms, in that particular study, it showed that women had a higher rate of heart attack and stroke. However in women who take estrogen alone because they've had a hysterectomy there was no increase in heart disease. There was more of a risk of breast cancer in the women who took combination hormone therapy. So I certainly say that's one option and if you decide to take hormone therapy you should work out with your doctor to find the best formula for you and to take it for a short period of time because the longer you take hormone therapy the risk of breast cancer increases.
Q: Women believe that osteoporosis is only for older women but that in fact is happening earlier, is that right?
A: Well, you start to lose bone in your thirties and it gets accelerated in menopause.
You should do plenty of weight bearing exercise like walking, running, dancing and strengthening exercises for your upper body. Cycling and swimming are good for your heart but not as good for bones because they're not as weight bearing.
You should get plenty of calcium from dairy and for vegetarians, soy milk and vegetables like broccoli. Dark green veggies have calcium and lots of folic acid - good for your heart too.
Q:What can you do to communicate more effectively with your doctors?
A. Bring in a list of questions and ask those questions at the beginning. You should be able to tell the doctor what your goal for the visit.
Q: We tend to gain weight at a certain age-what's that about?
A: One of the things that lower levels of hormones in women in their forties is that it decreases your tolerance to carbohydrates…..that's why you need to make some adjustments. Be more active, avoid sugar and starches - the gooey deserts and bread and potatoes. Cut back, because we don't metabolize them as quickly as we used to…..that's one of the big determinants of weight gain in menopause. And it makes you more insulin resistant - that's one of the metabolic changes. All of this contributes to getting apple shaped.
Stress is a real factor too. One of the stress hormones released is cortisol and that also helps contribute to apple shape or the belly fat.
Q.What do you do to keep yourself well, Dr Goldberg?
A. I exercise - That makes me the happiest - I exercise at a local gym, the 92nd Street Y in New York - I like to go to aerobics classes I like the support of the all the people around me. I do weight training exercise twice and my husband and I follow a healthy diet. But I do need some more work on stress management.
Q.Anything you would like to add?
A. Women are so good at multitasking so we want women to develop a healthy lifestyle that takes care of their whole body.
Nieca Goldberg, MD:
A Real Women's Doctor Speaks About Real Women's
Health Issues
My friends are calling me up with the same kinds of questions and I wrote this book in such a way that if your best friend was a doctor (this is) the inside information she would give you.
Q:Dr. Goldberg, you're an internist as well as a cardiologist, aren't you?
A: Yes I'm also board certified in internal medicine. So my training is to put the whole patient together and not just an organ at a time.
Q: This is not just for older women it's for younger women as well. What are some of the health issues women should be thinking about?
Geared Up to Go!
Here are some excellent tools to help you keep those New Year's Walking Resolutions you made not long ago. Or, if you're just starting anew, these resources will make you glad you decided to get up and go!
by Pamela La Gioia
You'll be traveling light and right in style with the Accomplish running sneaker from Receptor by ECCO.
I absolutely love these
shoes by ECCO. They're roomy
and comfortable, yet feel very secure. I'm really moving with my new walking program, and I've never felt better. Funny how a shoe can make such a difference. But they do!
Walking the Walk: Getting Fit With Faith Walk the walk at home and in spirit. Join Leslie Sansone in her inspirational thirty-day program, designed to help you create a healthier, fitter, more spiritual self.
Also a must-have: The Essential Walker's Journal, by Leslie Sansone. Using an planner style/diary format, Leslie helps you chart your progress through daily recordings of your walks. Includes area for keeping track of your daily nutrition.
Athlete's Oasis has created a simple system designed for today's walkers. Water containers you use in both hands at the same time, so body balance is maintained, alleviating the
negative effects of using
just one bottle. And,
there's a trigger that
allows you to open and
close your drinking valve
with only a slight nudge from
your thumb. All you have to do
is slip your hands between the
comfortable straps and you'll
be on your way to a
successful workout.
The Easiest Weight-Loss Plan Ever! Just Walk the Weight Away! Andrew Flach and Rosemarie Alfieri has created a workbook-based exercise, nutrition, and healthy living plan that's designed to get you off the couch and out the door—and loving it! Walk the Weight Away! eases you into a healthier lifestyle by combining stretching, walking, and light weight training exercises with healthy eating tips and tasty recipes.
The Apple iPod Shuffle must be the niftiest walking companion I've met. I consider it a "gotta have" if you want to walk without your CD player jiggling around a fanny pack, or restricting your hands or arms. Just clip on your Shuffle to your clothing and go!
Good Physical Function After
Age 40 Reduces Your
Risk of Stroke
People who have good physical function after the age of 40 may lower their risk of stroke by as much as 50 percent compared to people who are not able to climb stairs, kneel, bend, or lift as well, according to research published in the latest issue of Neurology, the medical journal of the American Academy of Neurology.
From 1993 to 1997, researchers examined nearly 14,000 men and women between ages 40 and 79 in the United Kingdom who had not suffered a stroke, heart attack or cancer. Researchers monitored how many strokes were suffered in this group through 2005.
The study found that people who reported good physical function -- regardless of age, sex, cholesterol level and other factors -- had a 50 percent lower risk of stroke than those with the lowest test scores. The better a person's physical function, the lower their risk of stroke.
"People who reported better physical function had significantly lower risk of stroke," says study author Phyo Kyaw Myint, MRCP, with the University of Cambridge in the United Kingdom. "This is independent of the known risk factors for stroke in the general population."
Myint says people with poor physical function may represent a high-risk population for stroke. "Physical function may identify apparently healthy men and women at an increased risk of stroke who may benefit the most from preventative treatments."
Myint says it's also possible that poor physical function may reflect underlying health issues, such as chronic inflammation, which may lead to vascular disease. He says increasing physical activity and eating more fruits and vegetables, which has been associated with better physical function, may also help to reduce stroke risk.
Other ways to help reduce the risk of a stroke include:
* Eating a low-salt, low-fat, low-cholesterol diet.
* Controlling high blood pressure.
* Quitting smoking.
The study was supported by Cancer
Research U.K., the Medical Research
Council (U.K.), and the Stroke Association (U.K).
For more information, visit the American Academy of Neurology's website at www.aan.com.
