Exercise Supports New Brain Cell Growth!!

New Neurons: Good News, Bad News

-- By Dr. Bill Klemm

for full article go to: http://www.sharpbrains.com/blog/2008/04/25/new-neurons-good-news-bad-news/

Exercise has been found important for human brain. Researchers have studied MRI images of exercising humans and found that the blood volume increased in the hippocampus in those subjects that underwent a three-month aerobic exercise program. Those subjects also performed better than controls on memory tasks. Such results indicated that new blood vessels had grown into the brain area. The inference is that this new blood supply was needed to support new neurons, and although there are other explanations, this is a reasonable speculation.

The Hippocampus and Memory.

The brain area known as the hippocampus is the one area where everyone agrees new neurons are born in the adult. The hippocampus is crucial for the for the conversion of certain short-term, scratch pad, memories into permanent form. Animal experiments have shown that the production of new neurons in the hippocampus is stimulated by enriched environments and by learning experiences. But do these new cells function normally? Do they support learning? And do these new neurons survive? Some animal observations indicate that new neurons in the hippocampus only live about one month.

Exercise Can Improve Brain function

Up Your Intelligence by Choosing Your Exercise Wisely

By Steve Knopper 04.21.08 | 6:00 PM

Get Smarter: 12 Hacks That Will Amp Up Your Brainpower

1: Distract Yourself

2: Caffeinate With Care

3: Choose Impressive Information

4: Think Positive

5: Do the Right Drugs

6: Juice Your IQ Score

7: Know Your Brain

8: Don't Panic

9: Embrace Chaos

10: Get Visual

11: Exercise Wisely

12: Slow Down

Plus: 6 Intelligence Myths Exposed

A Beautiful Mind: Steve Carell on How to Act Brilliant

The Memory Master: Want to Remember Everything You’ll Ever Learn? Surrender to This Algorithm.

Can exercise make you think better? In some cases, yes. Here's what works best.

Aerobic Training
Don't cut that PE class! In 2006, Arthur Kramer of the University of Illinois used MRIs to prove that aerobic exercise builds gray and white matter in the brains of older adults. Later studies found that more aerobically fit grade-schoolers also perform better on cognitive tests.
Impact on intelligence: Strong

Lifting Weights
When weight lifters talk about getting huge, they aren't referring to their hippocampus. Researchers have found only the most tenuous link between heavy resistance training and improved cognitive function. Got that, meathead?
Impact on intelligence: Negligible

Yoga
When facing a stressful situation or even a scary email, people often hold their breath. Yoga can break that habit. Under pressure, "most people breathe incorrectly," says Frank Lawlis, a fellow of the American Psychological Association and author of The IQ Answer. The result: more stress and less oxygen to your brain. "So the first thing that goes is your memory."
Impact on intelligence: Possibly strong

Studying on the StairMaster
A spinning class may rev up your mental muscle, but that doesn't mean you should study while huffing and puffing on the StairMaster. Research shows you'll just confuse yourself. "It's like doing something while you're driving," says Charles Hillman, a kinesiology professor at the University of Illinois. In other words, you won't do either task well.
Impact on intelligence: Negligible

Illustration: Christoph Niemann

Light Workouts

How Light Workouts Can Beat Hard Ones

source: http://www.realage.com/ct/shape-up-slim-down/workouts/tip/5644

We know how it is. The thought of sweating through a workout can turn couch gravity into an absolutely irresistible force.

But here's some good news for slackers: Easy, breezy, light exercise may do more for your energy levels than the hard stuff. So go ahead, put your workout on cruise control. Just this once.

Get up and go . . .
Research shows that a program of low intensity exercise training -- like light cycling on a stationary bike for 30 minutes three times a week -- can reduce tired-all-the-time feelings by as much as 65 percent. And it only takes 6 weeks of light workouts to feel pepped up. Moderate-intensity exercise programs boost energy levels, too, but not as much. (Know what the easiest workout in the world is? It's this.)

. . . got up and went
One possible explanation for the better energy boost from lighter workouts: More vigorous workouts shape you up but also tire you out. So if you're just trying to get off the couch for a change, start slow. Go at whatever pace is comfortable for you -- in a few weeks, you'll feel your tiredness fade. Then you can think about kicking things up a notch. (How fit are you? Check your current fitness level with this easy test.)

Energy Drain
So what's sapping your energy?

• Maybe you're drinking too much of this.
• Or maybe you're not getting enough sleep. Take this assessment to see if you might have a problem.
• Or maybe you've got a food allergy. Here's how to tell.
• Or maybe you need more B vitamins. Here's how a shortage will affect you.

Then again, it could be stress that has you feeling drained. Get stress-reduction strategies from other RealAge members on our Community Message Boards.

RealAge Benefit: Exercising regularly can make your RealAge as much as 9 years younger.

References Published on 04/24/2008.

A randomized controlled trial of the effect of aerobic exercise training on feelings of energy and fatigue in sedentary young adults with persistent fatigue. Puetz, T. W., Flowers, S. S., O’Connor, P. J., Psychotherapy and Psychosomatics 2008 Feb;77(3)167-174.

EDITOR'S PICK

The best workout is the one you enjoy so much that you forget you're doing it. Like peddling a beach cruiser around town, snorkeling through a cove, or dancing to the oldies at a picnic. It doesn't have to be work to work.

No Time to Exercise - Just Take a Walk!

Get in Step
Written by RealAge, Inc., peer-reviewed by Dr. Axel Goetz, November 2004

"Walking saved my life." So say many walking enthusiasts who picked up the habit and as a result either reduced their risk of disease, lost weight, beat depression, or enjoyed countless other major health rewards. Although you may not be surprised to know that walking is considered a superior health habit, it might surprise you to learn just how much research has confirmed the far-reaching and diverse health benefits that regular walkers experience. Read some personal accounts from the "Walking the way to Health" Initiative (WHI) of how walking changed these people's lives. Some doctors and scientists even believe that walking regularly can reverse illness and aging, making the simple act of walking quite possibly the most underrated prescription for good health. Read on to discover the long list of health wishes that walking can fulfill for you. 1. I wish I had more energy. A short brisk walk has both a calming and an energizing effect, according to research. And walking may help you feel more alert and well-rested because of its ability to improve the quality of your sleep. Walking at a moderate pace later in the day can help encourage deep, restful sleep. Finally, the mood boost you experience from walking may further enhance your energy levels. Walking toward a good night's sleep. In a study, people who walked more than 6 blocks per day reduced their sleep problems by one third. Using a "brisk" pace cut their sleep problems in half. 2. I wish I could think more clearly. Need to sort out some things in your head? Few activities help improve your perspective as quickly as a brisk walk, which will boost circulation in all parts of the body, including your brain. Some research also has shown that walking is associated with less cognitive decline and a reduced risk of dementia later in life. In addition to improving cognitive function, walking regularly can help you handle stressful situations and help you remain in control of your emotions, which clears the path for straight thinking. 3. I wish I could protect myself from my parents' diseases. Your genetics determine only a small part of your health profile. Research shows it's how you live your life that really counts, and walking regularly can prevent and improve many serious chronic diseases.

Here is a short list of ways that walking can reduce the impacts of disease. Moderately intense activities such as walking can:

•	Reduce cardiovascular disease by as much as 30-50 percent.
•	Decrease osteoarthritis pain, and improve stability, endurance, and agility.
•	Reduce the risk of colon cancer and possibly breast cancer.
•	Protect against diabetes in high-risk people, and lower blood glucose and improve insulin action in diabetics.
•	Lower blood pressure and reduce the risk of heart attack.

4. I wish I could lose weight. Although you might think that losing weight is the only way to enjoy an improved health profile, the truth is that regular walkers may not have to worry quite as much about what the scale says. Studies show that thin, sedentary

Find a walking event or walking club in your area in the American Volkssport Association (AVA) listings.

people may have more markers of heart disease risk than overweight people who exercise regularly.

Nonetheless, losing weight is a great way to improve your health profile and walking can help you accomplish this goal. Walking will increase the number of calories you burn each day and can boost your muscle mass, which in turn helps your body burn more calories throughout the day, not just while you are exercising.

5. I wish I felt happier in general.
Protecting and nurturing your mental health is an important part of overall wellness, and studies show that walking regularly

has the ability to lower your stress levels. Also, studies show that aerobic exercise such as walking may bring long-term benefits to your mental disposition by warding off both depression and anxiety. Steps toward better health No other prescription for your health is as free and easy as walking. It can even equal more vigorous forms of exercise in terms of its ability to improve your health profile. And it's easier on your body, especially your joints, than activities such as running. Do you know of any medicine that has greater benefits for your health and well being?

Don't think you have the time to walk? Just take a short walk in the morning and another at lunch or after work. Physical activity can be accumulated over the course of a day rather than all in one session, and it doesn't have to result in weight loss to have health benefits.

So start where you are and gradually increase the amount of time you spend walking. You'll gradually be granting yourself some very key health wishes in the process. RA

Benefits of Resistance Training

By: Janet Somer

Do you want to have a stronger and more beautiful body? Then the best thing to do is get on your feet and start doing the resistance training.

What Is Resistance Training?

Resistance training involves activities that use weights, machines and even body weight to work out the muscles properly. It is also known as strength training or weight training. This can be very helpful in achieving a healthier body.

This kind of training is usually associated with athletes who have to build up their bodies. Most people would think that when resistance training is done, the body will grow bigger. Actually it will not. Resistance training is simply about increasing the strength of the body, not its size.

Actually, this can be practiced by anyone. It basically builds and tones the muscle to give the body a better look. This training program is even very much advisable to the elders. The usual training programs undergone by the elders are standing free-weights resistance or the moderate-intensity seated machine training.

How Does Resistance Training Work?

A resistance training program will include the use of various exercise equipment and machines like the bench press, dumbbell or barbell. When the equipment is used, the muscles of the body will be pitted against the weight. The cells of the body will then adapt to the extra weight. This will then result to hypertrophy or the enlarging and increasing of the nerve cells to help in the muscle contraction.

Before doing any resistance training, it will be best to consult first with the doctor. This goes especially for people who have medical conditions or are overweight. This kind of training is not something that you can explore on your own. You have to know the proper equipment for the needs of your body. The body must also be conditioned first before taking in the weights.

Resistance training can also be done without resorting to the equipment. Doing push-ups is one good example. You can do it just about anywhere where there is enough space for you to move. This time it is your own body weight that will be pitted against the muscles. So those who are a bit constrained in the budget can still do resistance trainings.

What Are the Benefits of Resistance Training?

1 Increase Bone Mineral Density

Bones are constantly remodeling, meaning the tissues break down at the same time they build up. The peak of remodeling takes place during puberty. However, as a person ages, there may be problems with the bone mineral density as the remodeling may not be as active anymore. This is especially a problem to post-menopausal women.

Bone mineral density is usually supported by the hormones. To address the problem of not having the hormones to maintain the bone mineral density, physical activity is the next best option. Resistance training is one physical activity that can address this.

2. Increase Strength

Strong bones and strong muscles will be developed as you undergo the resistance training program.

3. Increase the Range of Activities

When your body is strong enough to carry some considerable weight, then definitely you will also be capable of doing more strenuous activities. You are less likely to be lazy and you can live a more active lifestyle.

4. Reduce the Body Fat

Pitting the weights on your muscle will definitely give it the body the exercise it needs and get rid of the undesirable fats. Thus expect the tone of the body to improve. Even more, expect the body to look better, to be leaner.

5. Improve State of the Elders

For the elderly, undergoing a resistance training program will help improve their health and decrease the risks brought about by the age. They can be more independent, without needing to rely on other people for doing simple things. Being able to do so will also decrease the risk of injuries in the elders

6. Improve Heart Condition

Regularly doing resistance training can result to a lowered heart rate and lowered blood pressure, especially after exercise. The risk of heart diseases is reduced to a considerable extent.

This kind of training however must be properly done. It requires commitment and consistency. It will have to be done in a regular basis, following a schedule that the doctor or the physical trainer would recommend. If done incorrectly, the benefits of the program may not be enjoyed and it can even result the injury.

The key here is to simply take your time. Do things one step at a time correctly. As your body condition improves, then move on to more challenging tasks. The strength of the body and its overall look are at stake in the resistance training. So you better be sure to do it properly.

Top 10 Traits of Highly Successful People

By: LeeDavidhcz

We have all read about people who are successful briefly. They win a gold medal, make a fortune, or star in one great movie…and then disappear. Or, there are those like Marilyn Monroe and Howard Hughes who achieve extraordinary success, at the cost of their own lives. These examples do not inspire me!

My focus and fascination is with people who seem to do well in many areas of life, and do it over and over through a lifetime. In entertainment, I think of Paul Newman and Bill Cosby. In business, I think of Ben and Jerry (the ice cream moguls), and a local hardware store owner who is famous for the money he’s give to children’s charities. As a Naval Officer, husband, businessman, politician and now as a mediator and philanthropist on the world stage, Jimmy Carter has had a remarkable life. We all know examples of people who go from one success to another.

These are the people who inspire me! I’ve studied them, and I’ve noticed they have the following traits in common:

1. They work hard! Yes, they play hard, too! They get up early, they rarely complain, they expect performance from others, but they expect extraordinary performance from themselves. Repeated, high-level success starts with a recognition that hard work pays off.

2. They are incredibly curious and eager to learn. They study, ask questions and read – constantly! An interesting point, however: While most of them did well in school, the difference is that they apply or take advantage of what they learn. Repeated success is not about memorizing facts, it’s about being able to take information and create, build, or apply it in new and important ways. Successful people want to learn everything about everything!

3. They network. They know lots of people, and they know lots of different kinds of people. They listen to friends, neighbors, co-workers and bartenders. They don’t have to be "the life of the party", in fact many are quiet, even shy, but they value people and they value relationships. Successful people have a rolodex full of people who value their friendship and return their calls.

4. They work on themselves and never quit! While the "over-night wonders" become arrogant and quickly disappear, really successful people work on their personality, their leadership skills, management skills, and every other detail of life. When a relationship or business deal goes sour, they assume they can learn from it and they expect to do better next time. Successful people don’t tolerate flaws; they fix them!

5. They are extraordinarily creative. They go around asking, "Why not?" They see new combinations, new possibilities, new opportunities and challenges where others see problems or limitations. They wake up in the middle of the night yelling, "I’ve got it!" They ask for advice, try things out, consult experts and amateurs, always looking for a better, faster, cheaper solution. Successful people create stuff!

6. They are self-reliant and take responsibility. Incredibly successful people don’t worry about blame, and they don’t waste time complaining. They make decisions and move on. Sometimes they are criticized for taking this to extremes – Jimmy Carter carried his own briefcase and a President "shouldn’t" do that! Extremely successful people take the initiative and accept the responsibilities of success.

7. They are usually relaxed and keep their perspective. Even in times of stress or turmoil, highly successful people keep their balance, they know the value of timing, humor, and patience. They rarely panic or make decisions on impulse. Unusually successful people breath easily, ask the right questions, and make sound decisions, even in a crisis.

8. Extremely successful people live in the present moment. They know that "Now" is the only time they can control. They have a "gift" for looking people in the eye, listening to what is being said, enjoying a meal or fine wine, music or playing with a child. They never seem rushed, and they get a lot done! They take full advantage of each day. Successful people don’t waste time, they use it!

9. They "look over the horizon" to see the future. They observe trends, notice changes, see shifts, and hear the nuances that others miss. A basketball player wearing Nikes is trivial, the neighbor kid wearing them is interesting, your own teenager demanding them is an investment opportunity! Extremely successful people live in the present, with one eye on the future!

10. Repeatedly successful people respond instantly! When an investment isn’t working out, they sell. When they see an opportunity, they make the call. If an important relationship is cooling down, they take time to renew it. When technology or a new competitor or a change in the economic situation requires an adjustment, they are the first and quickest to respond.

These traits work together in combination, giving repeatedly successful people a huge advantage. Because they are insatiable learners, they can respond wisely to change. Because their personal relationships are strong, they have good advisors, and a reserve of goodwill when things go bad. And finally, none of these traits are genetic! They can be learned! They are free and they are skills you can use. Start now!

Visit Eruptingmind for Free Self Improvement Tips

Making Friends - Tips

Friendships Enrich your life & Improve your health

Source: http://www.mayoclinic.com/health/friendships/MH00125 (for full article)

Developing friendships does take some work.

But because friendships are so important to your overall sense of well-being, it's worth the time and effort.

Here are some ways you can develop new friendships:

• Get out with your pet. Seek out a popular dog park, make conversation with those who stop to talk on your daily neighborhood jaunts, or make pet play dates.
• Work out. Join a class through a local gym, senior center or community fitness facility. Or start a lunchtime walking group at work.
• Do lunch. Invite an acquaintance to join you for breakfast, lunch or dinner.
• Accept invites. When someone invites you to a party, dinner or social gathering, say yes. Resist the urge to say no just because you may not know everyone there or you may initially feel awkward. You can always leave if you get too uncomfortable.
• Volunteer. Hospitals, places of worship, museums, community centers and other organizations often need volunteers. You can form strong connections when you work with people who share a mutual interest.
• Join a cause. Get together with a group of people working toward a goal you believe in, such as an election or the cleanup of a natural area.
• Join a hobby group. Find a nearby group with similar interests in such things as auto racing, music, gardening, books or crafts.
• Go back to school. Take a college or community education course to meet people with similar interests.
• Hang out on your porch. Front porches used to be social centers for the neighborhood. If you don't have a front porch, you can still sit out front with a cup of coffee or a good book. Making yourself visible shows that you are friendly and open.

You may not become instant friends the first time you meet someone. But the seeds of lasting friendships can be sown with a friendly wave as you're mowing the lawn or bringing in the newspaper.

Keep friendships nurturing and healthy

Developing and maintaining healthy friendships involves give and take. Sometimes you're the one giving support to your friends, and other times you're on the receiving end. Letting friends know you care about them and appreciate them will help ensure that their support remains strong when times are rough. It's as important for you to be a good friend as it is to surround yourself with good friends.

Here are some ways to make sure your friendships remain healthy and supportive:

• Go easy. Don't overwhelm friends with phone calls or e-mails. Communication can be brief — five minutes on the phone or several sentences in an e-mail. Find out how late or early you can call and respect those boundaries. Do have a plan for crisis situations, when you may need to temporarily set aside such restrictions.
• Be aware of how others perceive you. Ask a friend for an honest evaluation of how you come across to others. Take note of any areas for improvement and work on them.
• Don't compete. Don't let a friendship turn into a hidden battle over who makes the most money, has the best clothes or the coolest car. Don't fight over other friends. This will only turn friendships into unhealthy rivalries.
• Adopt a healthy, realistic self-image. Both vanity and constant self-criticism can be turnoffs to potential friends.
• Resolve to improve yourself. Cultivating your own honesty, generosity and humility will enhance your self-esteem and make you a more compassionate and appealing friend.
• Avoid relentless complaining. Nonstop complaining is tiresome and draining on friendships. Talk to your friends about how you can change the parts of your life that you're unhappy about.
• Adopt a positive outlook. Try to find the humor in things. Laughter is infectious and appealing.
• Listen up. Make a point to ask what's going on in the lives of your friends. Don't talk about your own problems all the time. Friendships can't last when you're self-absorbed.

Friendships pay dividends

Friendships provide a sense of belonging and comfort. Friendships act as a buffer against life's hardships and help you develop resilience. They offer compassion and acceptance. And friendships can make you feel important and needed by giving you a chance to offer someone else comfort and companionship, too.

Relationships change as you age, but it's never too late to build new friendships or reconnect with old friends. The investment in your friends will pay off in better health and a brighter outlook for years to come.

RELATED

• Reduce stress with a strong social support network
• Spirituality and stress relief: Make the connection

By Mayo Clinic Staff

Excess Abdominal Fat increase Death Risk in Women

Excess Fat Around the Waist May Increase Death Risk For Women

http://www.nih.gov/news/health/apr2008/niddk-07.htm

Women who carry excess fat around their waists were at greater risk of dying early from cancer or heart disease than were women with smaller waistlines, even if they were of normal weight, reported researchers from Harvard and the National Institutes of Health.

Previous studies have shown that the tendency to deposit fat around the waist increases the risk for health problems. The current study is the largest, most comprehensive of its kind undertaken to show that accumulation of abdominal fat can increase the risk of death.

To conduct the study, the researchers analyzed data from more than 44,000 women in the Nurses’ Health study, which followed the health history of thousands of registered nurses in 11 states.

"As we know from the work of the NIH Obesity Research Task Force, reversing the epidemic of obesity is challenging," said Elias A. Zerhouni, M.D., Director of the National Institutes of Health. "The current findings highlight the role that research can play in understanding the risks of obesity."

The research team that conducted the study was led by Cuilin Zhang, M.D., Ph.D., of NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). Dr. Zhang conducted much of her work on the study while at the Harvard School of Public Health. She concluded her analysis after joining the staff of the NICHD. The study was conducted in the research group of Dr. Frank Hu, M.D., Ph.D., of the Harvard School of Public Health, and by researchers from Brigham and Women’s Hospital and Harvard School of Medicine.

Funding for the study was provided by the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases and the National Cancer Institute. The Nurse’s Health Study was supported by NIH’s National Heart, Lung and Blood Institute.

The study was published online in Circulation.

There is increasing evidence that excess abdominal fat is a risk factor for long-term conditions like diabetes and heart disease. However, the relationship between abdominal obesity and risk of death has not been widely studied. The current study is one of the largest extended investigations of abdominal obesity and women’s risk of premature death.

Researchers followed more than 44,000 women over the course of 16 years to track their medical history and lifestyle. Because the majority of the women who took part in the study were white, the researchers do not know if their findings pertain to other groups of women or to men.

All the women included in the study were registered nurses. At the beginning of the study the women were asked to measure their waists and hips. Every two years, the women completed questionnaires about their health, providing information about their age, activity level, smoking status, diet, blood pressure and cholesterol levels.

The researchers examined the cause of death for all women who died over the course of the study. In total, 3,507 deaths occurred — of these, 1,748 were due to cancer and 751 were due to heart disease.

The researchers discovered that women with greater waist circumferences were more likely to die prematurely, particularly from heart disease, when compared to women with smaller waists. For example, women with waist size equal to or greater than 35 inches were approximately twice as likely to die of heart disease as were women with a waist size less than 28 inches, regardless of their body mass index. Similarly, women with a waist size equal to or greater than 35 inches also were twice as likely to die of cancer as were women with a waist size less than 28 inches.

Women who had a greater waist circumference and were also obese were at the greatest risk of premature death. Researchers determined if a woman was overweight by calculating her body mass index (BMI), a measure of a person’s weight in relation to height. BMI is used to estimate the proportion of a person’s weight that derives from body fat. A BMI between 18.5 and 24.9 is considered healthy. A BMI of 30.0 - 39.9 is regarded as obese.

Greater waist circumference is a sign of collecting excess fat around one’s midsection, called abdominal obesity. According to the Clinical Guidelines on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults published by NHLBI in cooperation with NIDDK in 1998, a healthy waist limit for women is 35 inches and, for men, 40 inches. Waist circumference is determined by measuring around the waist at the navel line. The NHLBI lists information on waist circumference and BMI at http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/risk.htm

In 2004, over one-half of U.S. adults had abdominal obesity by these standards, said Dr. Zhang.

The researchers also studied waist-to-hip ratio — a measure of the narrowest part of the waist compared to the circumference at the broadest part of the hip — as a potential determinant of mortality risk. Waist-to-hip ratio was found to be as strongly associated with risk of early death as the measurement of waist size alone. However, waist-to-hip ratio requires two measurements and therefore may be less convenient to calculate than measuring waist circumference alone, said Dr. Zhang.

The study authors wrote that results from previous studies have been inconsistent because of the relatively small number of people who took part and the short duration of the studies. The current study provides the strongest evidence so far regarding the adverse effects of abdominal obesity on the risk of death in women. The authors called for future studies to investigate abdominal obesity and the risk of death in men and other ethnic groups.

"Although maintaining a healthy weight should continue to be a corner stone in the prevention of chronic diseases and premature death, maintaining a healthy waist size should also be an important goal," the study authors wrote.

Learn more about weight control, obesity, physical activity, and related nutritional issues from NIDDK’s Weight-control Information Network at http://win.niddk.nih.gov. For Weight and Waist Measurement: Tools for Adults, visit http://win.niddk.nih.gov/publications/tools.htm.

Learn more about ways to maintain a healthy weight based on the Clinical Guidelines Expert Panel Report, visit the NHLBI’s Aim for a Healthy Weight Web site http://healthyweight.nhlbi.nih.gov.

To calculate your BMI and assess your risk for conditions related to overweight and obesity, visit http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/risk.htm.

Information about obesity, weight, physical activity, diet, and cancer is available at. http://www.cancer.gov/cancertopics/energybalance.

Information about the Nurse’s Health Study is available at http://epi.grants.cancer.gov/ResPort/NursesHealthI.html.

The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute’s Web site at http://www.nichd.nih.gov/.

Hormone Replacement & Menopause

Hormone replacement therapy and your heart

source: http://www.mayoclinic.com/health/hormone-replacement-therapy/WO00131

Are you taking — or considering — hormone therapy to treat bothersome menopausal symptoms? Understand the risks to your heart and how to minimize them.

In the 1980s and 1990s, doctors in the United States routinely recommended long-term hormone replacement therapy to postmenopausal women to treat menopausal symptoms and to prevent heart disease. In 2002, this practice stopped abruptly, when studies showed that hormone replacement therapy may actually increase the risk of heart disease rather than prevent it. Yet, hormone replacement therapy remains the most effective treatment for bothersome menopausal symptoms, such as hot flashes and vaginal dryness.

For women who are approaching — or facing — menopause, these contradictory conclusions about hormone replacement therapy can seem impossible to reconcile. If you're having a tough time with symptoms of menopause but worry about how hormone replacement therapy will affect your heart, try to put your personal risk into perspective. The absolute risk of heart disease to an individual woman taking hormone replacement therapy — now called hormone therapy — is quite low. If you experience moderate to severe hot flashes and other menopausal symptoms, the benefits of hormone therapy may outweigh your potential risks.

Hormone therapy and heart disease: What's the connection?

Around the world, women have a lower risk of heart disease than do men. Doctors and researchers have long attributed this difference to the female hormone estrogen. And they've blamed the declining levels of estrogen after menopause for the increase in heart disease as women age.

For decades, observational studies seemed to demonstrate the protective power of estrogen — not just before menopause, when your ovaries produce estrogen naturally, but also after menopause, when supplied by pills, skin patches and other preparations.

Then came the Women's Health Initiative (WHI), a large clinical trial expected to confirm the benefits of hormone therapy. Its surprise finding: Not only did postmenopausal hormones fail to protect women from heart disease — hormone therapy actually made older women more likely to have heart attacks, blood clots and strokes.

What were the results of large clinical trials on hormone therapy?

According to the WHI, for every 10,000 women taking estrogen plus progestin for one year, there would be:

• Seven more cases of heart disease
• Eight more cases of breast cancer
• Eight more cases of stroke
• 18 more cases of blood clots

For women in the study taking estrogen alone (Premarin), the WHI found no increased risk of breast cancer or heart disease. But researchers did find that over one year, 10,000 women taking estrogen, compared with a placebo, might experience 12 more cases of stroke and six more cases of blood clots in the legs.

The findings of the WHI were not all bad, though. Women in the study who took combination hormone therapy experienced fewer hip and vertebral fractures than normal.

However, for most women, the exact number of blood clots and hip fractures isn't the most important information gleaned from the WHI. The key message of this study is simply that hormone therapy shouldn't be given to all women — like a vitamin — to make them live longer.

Current recommendations

Doctors no longer prescribe hormone therapy to prevent heart disease and other chronic conditions affecting postmenopausal women. Today, however, the fear of using any postmenopausal hormone therapy at all has subsided. That's partly because continuing analysis of WHI data points to a middle ground rather than an all-or-nothing approach to hormone therapy.

It's also still possible that hormone therapy confers some protection from heart disease when taken early in your postmenopausal years. A randomized, controlled clinical trial — the Kronos Early Estrogen Prevention Study (KEEPS) — exploring estrogen use and heart disease in younger postmenopausal women is under way, but it won't be completed for several years.

What should you do?

To an average woman, the added heart risk from hormone therapy is no cause for alarm. Your individual risk of developing heart disease depends on many factors, including family medical history, personal medical history and lifestyle choices. Talk to your doctor about your personal risks. Chances are, they aren't significant enough to preclude hormone therapy for menopause symptoms.

But if you already have heart disease or you have a history of blood clots, proceed with caution. Work with your doctor to find the safest, most effective treatment for your menopause symptoms.

If you take hormone therapy, how can you limit the added risks?

• Start hormone therapy early. In the WHI, hormone therapy caused no significant increase in heart disease risk in women under age 60.
• Minimize the amount of medication you take. Use the lowest effective dose for the shortest amount of time needed to treat symptoms.
• Try a form of hormone therapy with limited systemic effects. Estrogen and progestin are available in many forms, including pills, skin patches, gels, vaginal creams and slow-releasing suppositories or rings that you place in your vagina. Some studies show that the route of medication administration may affect the risk of heart disease. There is some evidence that skin patches pose less risk of heart disease than do pills.
• Make healthy lifestyle changes. Counter the risks of hormone therapy by making heart-healthy lifestyle changes. Don't smoke or use tobacco products. Get regular physical activity. Eat a healthy diet focusing on fruits, vegetables, whole grains and low-fat protein. Maintain a healthy weight. And get regular health screenings to check your blood pressure and cholesterol levels to detect early signs of heart disease.

It's a balancing act

Women of all ages should take heart disease seriously. It's the leading cause of death for women 65 and older, the third-leading cause of death for women 25 to 44 and the second-leading cause of death for women 45 to 64.

At the same time, most women can safely take short-term hormone therapy for menopausal symptoms without significantly increasing the risk of heart disease. If you experience severe vaginal symptoms or wake up at night with hot flashes, don't avoid hormone therapy for fear of its risks. Instead, talk to your doctor about how you can relieve troublesome symptoms while protecting your heart.

RELATED

• Hormone therapy: Is it right for you?

Web Resources

• Kronos Early Estrogen Prevention Study (KEEPS)
• Women's Health Initiative