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Dr. Peter Klatsky: When Less is More... Mammography and Paps

2009-11-23T01:16:45Z

Last week, leading experts correctly challenged long held practices in women's health. Despite the evidence, doctors and patients, as well as political and community leaders hotly debated these recommendations. My heart sank when Kathleen Sebelius, Director of Health and Human Services (HHS) weighed in and suggested that women ignore the recommendations and continue doing what they have been doing. I was astounded.

Ask any good surgeon or physician (preferably one who does not own a diagnostic machine) and we can all tell you nightmare stories about patients who have been hurt (sometimes severely) by overzealous screening and unnecessary interventions. Still, it is hard to stop something that you have been trained to do or advocate.

I still shudder, when I hear colleagues suggesting that women should perform clinical breast exams each month. We have known for over a decade that teaching women to examine themselves once a month does not prevent or improve detection of breast cancer. It does lead to more biopsies, surgeries, and anxiety (with increased cost and no benefit). The evidence against breast self exams is strong and robust. Women who identify lumps should still contact their doctors, but performing planned screening in the shower every month is simply ineffective and harmful.

Yet it's hard to stop something your doctor told you to do 30 years ago. It's also hard to stop telling patients something you learned in medical school 20 years ago. All of these recommendations represented our best advice at the time. Fortunately, we continue to learn and grow, and so must our advice.

The recommendations announced last week by the US Preventive Services Task Force (USPSTF) and the American College of Obstetrics & Gynecology (ACOG) that women reduce the number of mammograms and pap smears they receive were both founded in strong science and empiric evidence. Unfortunately, the USPSTF article reads like Greek to most non-physicians and non-statisticians.

Its critically important to realize that the men and women who develop these guidelines have no "skin in the game." They do not benefit from reducing the number of mammograms or pap smears. They're not heartless bureaucrats trying to save a few dollars. Both the USPSTF and ACOG are composed of physicians and scientists whose only motivation is to improve the health and wellness of women nationwide. Being invited onto the USPSTF or ACOG Practice Committee is a huge honor. These are our best and brightest. They strive to determine what is best for our patients, our community, and our loved ones.

Back to the reaction of Secretary Sebelius: When the captain of the ship ignores the engineer's suggestion regarding engine maintenance, it's a problem. The USPSTF is sponsored and funded by the HHS. By ignoring their recommendations on mammography, the Secretary demonstrated why the federal government has been unable to reign in healthcare costs: Even when testing is found to be more harmful than beneficial, our leaders and some in the media still demand more tests.

The current health reform bills have done little to change the incentives and drivers of increased healthcare costs. When good evidence suggests that increased testing provides no benefit, we should stop such testing. Meanwhile, as health care costs continue to grow, it crowds out money for other important areas, like education. Can we really demand medical tests that our experts suggest are unhelpful, while we increase class size in schools and cut funding to schools and our teachers?

These problems are connected. Sometimes good intentions can do more harm than good. The trust between a doctor and patient is sacred and doctors still need the ability to make individualized decisions given a patient's unique medical history. However, when it comes to standard protocols and recommendations, we must act based on the best evidence, weighing not only the benefit, but also the cost and potential for harm from a given test or treatment.

The next time a friend goes under anesthesia for a stressful, painful but benign breast biopsy, or the next time a young woman has a preterm delivery after part of her cervix was removed for an abnormal pap smear she had at age 20 (most of which resolve with time), I hope we remember that sometimes in medicine, less is truly more.

Roseanne Colletti: Cancer Confusion for Women

2009-11-23T00:43:46Z

I don't know about you, but I'm confused. Who is telling me the truth about mammograms and Pap smears? A federal panel says women can wait until 50 for yearly mammograms. A group representing obstetricians and gynecologists advises women can wait until 21 for their first screening for cervical cancer.

For years, women have been advised to get annual mammograms beginning at age 40. Even teenagers were told to get yearly Pap smears within three years of becoming sexually active.

In truth, while women young and old have been scheduling those yearly doctor visits, the rates for both cervical and breast cancers have dropped dramatically. Since the onset of regular mammography screening in 1990, the breast cancer mortality rate has dropped by almost a third. The cervical cancer rate has declined by half, with credit given to the yearly Pap smear.

Most women won't get breast cancer. More women will get breast cancer after 50 than before. However, a full 40% of the lives saved by mammograms are among women 40-49. These figures come from both the American Cancer Society and the American College of Radiology.

What was Health and Human Services Secretary Kathleen Sebelius trying to say when she backed away from the panel's mammogram recommendations? After all, she heads the federal department that is advised by the panel. What does this tell you? Are their recommendations incorrect or just unpopular? Is this good science and bad medicine? What are women who have been taught to fear breast cancer all of their lives to think?

"My patients are angry," says Manhattan oncologist, Dr. Bonnie Reichman, clinical associate professor of medicine at Weill Cornell Medical College. "This is setting us back 20 years in all of the strides we've made in early detection and treatment of breast cancer," says Reichman.

"I was diagnosed at 54, but I know a lot of women who were in their 40's," says Tanya Adkins, a breast cancer survivor. Where would these women be without early screenings? It's statistically correct to say the numbers are smaller in younger women, but if you're among that number, it's your life.

"Only 50% of women over 40 go for mammograms as it is, "says Dr. Kathy Plesser, a board certified radiologist in Manhattan. "We need to tell these women to go, not others to stop going."

When it comes to cervical cancer screenings, confound it, I'm confused again. A prominent group representing the very doctors who specialize in treating women, says women can now wait until 21 for their first cervical screening. The group says abnormal Pap smears in teenage women leads to unnecessary procedures that can damage the cervix and have led to an increased number of premature births.

Does it only strike me as odd that the new recommendation may place the health and well being of the young female behind the success of a future pregnancy that may or may not happen? If there are unnecessary treatments that may be harmful, why aren't doctors looking more at improving or reducing these treatments than delaying the initial screening, which remember is credited with reducing cervical cancer by 50?

Teenage women rarely get cervical cancer. It is a slow growing disease caused by certain strains of the human papillomavirus (HPV), a common sexually transmitted disease. Generally, the immune system will clear up the HPV infection within one to two years among most adolescent women.

There is a higher incidence of HPV-related precancerous lesions in adolescent women, but most cervical dysplasias in teens resolve on their own without treatment. Treatment may be unneeded, but a doctor and patient can't even talk about that without the initial screening.

With delays in these screenings can we expect the cancer rates to increase? "I would expect the rates to go back up and I certainly won't be following any of these recommendations," says Dr. Thomas Caputo, the chief of the division of Gynecologic Oncology at NY Presbyterian/Weill Cornell Medical Center.

In putting forth their recommendations, both auspicious groups did express and advantage in decreased costs. Treating a man or woman with cancer costs a lot of money. The screenings are by comparison inexpensive. Again, I'm confused.

(For more of my stories and to see Gossip Gram go to nbcnew york.com.

Waylon Lewis: Method's Dirty, Dirty Video Spoof Against Toxic Household Cleaners

2009-11-22T20:22:39Z

Did you know that chemical companies, cough, I mean cleaning products companies don't have to say what they put in their toxic laboratory-birthed neon "cleaning" products?

Here's Method's "Shiny Suds" video spoof of..."a cleaning product commercial in which a mom gets a nasty shock in her shower from some creepy animated cleaning characters."

Chemicals aren't Clean !

How to support Congress' passage of the Household Product Labeling Act of 2009!

Did you know that chemical companies, cough, I mean cleaning products companies don't have to say what they put in their toxic laboratory-birthed neon "cleaning" products?

Want an easy way to support the Household Product Labeling Act? Click here.

"Method's campaign offers a call to action for viewers to support the Household Product Labeling Act of 2009, a bill that has been introduced in Congress and would require household cleaning products to be clearly labeled with complete ingredient disclosure. Method supports this bill and encourages companies to be transparent in their product labeling.
The video is meant to be entertaining while also provoking viewers to think about the chemicals they are using and breathing while cleaning. Many of us are simply not aware that traditional cleaners are full of ingredients that are harmful to the environment and potentially harmful for ourselves and our families."

Richard Laermer: Science Says We're Unhappy -- So Let's Change

2009-11-22T13:11:45Z

Strange news from polling data has come up to smack us in the head. And I don't like it.

Gallup's latest oddly-named Lifestyle Poll statistically showed that Americans are less satisfied now with their lives than at any time since 1992! While historically we are less satisfied during tough economic times, this poll produced a single shocking stat: Only 47% of Americans are "very satisfied" with what's going on. That's the first time this number has been under 50% since Gallup started measuring data like this back in '79.

"In general are you satisfied or dissatisfied with the way things are going in your personal life.." went the question from Gallup to thousands of at-home respondents (who has a landline these days?). "Americans are not quite as personally satisfied as they have been in the past, in the midst of one of the worst economies in decades; however, it is notable that such a poor economy can affect personal satisfaction only so much."

If only 47% of us are "very," that has to say 53% of us are "not very." If we aren't - then what the hell are we doing? Americans are stuck in neutral and don't know which way to turn. Do you want to be idling in mud? Me neither.

I find that real personal change comes from making better - and more - impressions. Unless you live in a no-man's-land you are spinning around humans. And everything that happens, happens with others hanging on. But, you can get to where you need to go without making stressful wholesale changes. You have to make tiny adjustments to how you are seen--being consistent! You have to be sure that everyone you come in contact with meets the Model You, the one you put there that's shiny and new.

Or you can hang out with the 53% of who aren't very satisfied with life. It is, as always, a choice. Choosing to stand out can make a difference between having everything you've ever wanted and wallowing in a fifth circle of mediocrity among the other Americans who stand there with their arms folded.

New Twitter Feed for the "How To Fame" project: @howtofame
Find more of me: Laermer.com

Dana Ullman: Don't Confuse Real Healing With Suppression Of The Disease

2009-11-22T12:00:00Z

Anyone who has taken a painkiller certainly knows that there is a big difference between temporary relief and real healing. Even though a person who takes a painkiller may not consciously feel pain, it is widely understood that this relief does not necessarily mean that a "cure" or a “healing” has occurred.

And yet, it is surprising how many people think that various conventional drugs have performed some type of miracle just because they provided short-term relief of pain or discomfort. Little do many people know that when a drug “works,” this may be the “bad news.” It may be that the drug works by suppressing the disease, thereby creating a much more serious physical and/or mental disease.

Although antibiotics and select other drugs may be an exception to this general observation, getting rid of an infection will not influence the immune factors that led the person to be susceptible to infection in the first place, and in fact, antibiotics are known to disrupt one’s inner ecology, disturb assimilation of nutrients, and even tend to make the person more susceptible to new infection (a future blog will deal more directly with this issue).

Painkillers, on the other hand, may provide great reduction in pain, but this may result in the person continuing to walk on that injured ankle and cause increased injury. The person with arthritis, as another example, may continually take one or more painkilling drugs that provide some relief but these drugs also create their own tolerance, addiction, or pathology, usually leading to much more serious health problems.

A smart person might consider taking a conventional drug that provides temporary blessed relief while concurrently seeking some more deep treatment that nourishes, nurtures, or augments the body’s own defenses. A problem, however, is created when a sick person frequently relies upon a drug to provide temporary relief and does not seek a real, more profound healing.

Differentiating Real Healing from Suppression of Disease

When a person experiences relief from any treatment, conventional or alternative, one should not necessarily assume that a real healing has occurred. While it is possible that the person may really have been healed, it may also mean:

the symptoms went away on their own, and the treatment had nothing to do with it.
the treatment palliated the symptoms, providing short-term relief but resulted in the recurrence of symptoms in the near future.
the treatment “worked” by suppressed the person’s symptoms or his/her own immune and defense system, thereby pushing the disease deeper into body. Although suppression of symptoms may cause them to disappear, they tend to be replaced, sooner or later, with more serious, deeper symptoms that are more discomforting and potentially dangerous.

Homeopaths and naturopaths both assert that there is a big difference between real healing, palliation of symptoms, and suppression of disease, even though each of these results may initially seem to be the same.

What people don’t usually understand is that there may be a danger in the frequent or recurrent application of treatments that suppress symptoms. The concept of suppressing symptoms is well accepted and understood in psychology. It is commonly observed when a person suppresses his or her emotions, such actions tend to push the emotional turmoil deeper, leading the person to explode at some future time, often at people who are not directly related to the origin of the person's problem.

While people may be familiar with the problems associated with the suppression of emotions, people are generally not familiar with the possibility that many conventional medical treatments can suppress their physical symptoms, driving the disease deeper into the person. And yet, suppression of disease is so commonplace in today’s medical treatment that it is virtually ignored.

Doctors and drug companies tend to minimize the real problems of suppressing the disease process by referring to the “side effects” of a drug. And yet, pharmacologists commonly note that the determining a drug’s “effects” and its “side effects” are completely arbitrary. They are both the direct effect of the drug upon the human body.

Ironically, many conventional drugs are touted specifically for their ability to “suppress” symptoms…or even suppress the body’s own immune system. Ultimately, pushing the disease deeper into the person is the result of using pharmacological agents that are explicitly prescribed for their ability to control or inhibit symptoms that are the natural defensive functions of the body. Suppression of disease may provide the semblance of benefit (or at least short-term benefit), but ultimately may make the person much sicker. Such suppression of the disease process may lead to increased chronic disease, immune dysfunction, and mental illness, all of which we are seeing together in epidemic proportions.

Understanding the Healing Process from a Whole Systems Perspective

The father of American homeopathy was a German physician named Constantine Hering, MD (1800-1880). Hering was a respected conventional physician who was hired by a publisher to write a book critical of homeopathy, and in his research on the topic, he became convinced of its efficacy. After many years of practicing homeopathy, he observed that people go through a specific healing process after being given the correct homeopathic medicine. He developed guidelines in which to determine when a real healing is taking place. These guidelines have been called "Hering's laws of cure," but some homeopaths prefer to call them “Hering's guidelines of cure.”

To understand these guidelines, it is first useful to know that homeopaths carefully evaluate the evolution of a person's physical, emotional, and mental/spiritual symptoms. Homeopaths consider mental/spiritual symptoms to be deepest to the core of a person's being for they represent the will, the ego, the sense of security that the person feels, and the person's overall state of consciousness. Homeopaths today wonder if the immune system’s important ability to identify “self” from “non-self” is dynamically connected to a person’s mental/spiritual state of health, thereby linking mind and body health. The emotional symptoms are external to the mental/spiritual level of the person because imbalances in the deeper level will create increased propensities to various fears, angers, depressive states, and other emotions. The physical symptoms are the most outer manifestation of the person, though every level can and will influence the other.

Also, each level has certain symptoms that have more or less influence on a person's overall health. For instance, a person's asthma will be deeper than his or her skin rash, a person's fear of death will be deeper than his or her irritability, and a person's loss of self esteem will be deeper than a subtle reduction in memory. Likewise, when comparing symptoms on different levels, a person's heart disease will more profoundly affect his or her health than a difficulty in concentration experienced on the mental/spiritual level.

In light of these levels of the human being and the degrees of intensity to which a symptom impairs a person's ability to live, Hering found that healing progresses:

· From within to without (from the deepest part of our being to the most external);

· From the most recent disease back in time to previous ones (a reversion of the disease process);

· From the top of the body to the bottom of the body.

Ultimately, basic concepts of survival and evolution are at the heart of this understanding of the defenses of the body. The human body can and will defend its most vital functions first before defending its more superficial functions.

Homeopaths observe that a truly effective therapy sometimes elicits a temporary exacerbation of certain symptoms, usually in the superficial ones or sometimes ones that the person had many years previously. Homeopaths assert that a true healing is taking place when a person's present symptoms are more superficial than previous ones. One of the reasons that homeopaths and their patients have come to believe that homeopathic medicines are not simply placeboes is their observations that some symptoms tend to increase in the process of a curative response (healing from within to without…and the above other guidelines).

This “externalization” of symptoms is commonly observed by homeopaths who witness that approximately 20-30 percent of their patients with a chronic illness tend to experience skin symptoms, nasal or bronchial discharges, diarrhea, early menstruation with clots, profuse perspiration, or some other externalization of the disease process after an effective homeopathic treatment is provided.

On the other hand, if and when a person takes a conventional drug and his or her symptoms disappear but new ones that are more serious develop, this result suggests that the treatment has suppressed the person's condition and has made them worse. Unknown to most physicians and patients, people undergoing conventional medical treatment are commonly having their disease suppressed. Homeopaths assert that one of the reasons that there is increased mental disease and increased chronic disease at earlier and earlier ages is because of effective suppression of the disease process by conventional medical treatment.

Distinct from methods that suppress disease are those that help disease express and externalize itself. Homeopathy's use of the principle of similars (using medicines bases on their ability to CAUSE the similar symptoms that the sick person is experiencing) is one important safeguard against disease suppression because it mimics the wisdom of the body rather than suppresses its symptoms.

I like to call homeopathy a type of “medical biomimicry” because a homeopathic medicine is chosen for its ability to mimic the symptoms that the sick person is experiencing. Because there is a certain wisdom to the bodymind, mimicking this wisdom is a good way to elicit a real healing.

Dana Ullman, MPH, is America's leading spokesperson for homeopathy and is the founder of www.homeopathic.com . He is the author of 10 books, including his bestseller, Everybody's Guide to Homeopathic Medicines. His most recent book is, The Homeopathic Revolution: Why Famous People and Cultural Heroes Choose Homeopathy. Dana lives, practices, and writes from Berkeley, California.

Joseph Sciabbarrasi, M.D.: What You Don't Know About Osteoporosis -- Part 3

2009-11-22T12:00:00Z

In this, our final segment on Osteoporosis, let's take a closer look at some of the myths and legends of the effects of eating meat, minerals and proteins and quaffing a pint or two. You can find the two previous segments here.

Vegetarians, Carnivores and Osteoporosis

While bone mineral density may be a tad or more low in vegetarians, the notable and well documented results are in: vegetarians do not have an increased risk of fractures. Their risk for busting a hip is no better, no worse than those of us who eat meats, even though the vegetarian's diet is typically lower in calcium and some vitamins. We already know about calcium and its lack of relationship to osteoporosis except at extremely low levels. But the fact remains that a diet lower in protein from animal sources or one entirely devoid of all animal products still provides every bit of protection -- or the lack thereof -- that we see in other folks (1, 2).

Menopausal Chinese women maintain bone mineral density with soy intake - though significant loss of bone can occur in very elderly Chinese. Similarly, Caucasian women maintain or increase bone density by their consumption of soy protein. In fact, two glasses of soy milk a day prevents bone loss in the spine of menopausal women with osteoporosis (3).

But interestingly, if Progesterone is added to those drinking soy, bone loss will occur (at least in this study of 89 women).

Apparently, too much of a good thing. Progesterone by itself increased bone density. Soy milk by itself did the same. But apparently you can't mix them together without cancelling all benefit.

And if you think that's not fair, read this.

For a while we thought the more vegetable protein we ate, the stronger our bones would be. Or, to paraphrase, the more animal protein you ate, the more likely you were to break a bone (4). This was the theory that vegetable protein (an alkaline diet), was superior to animal protein (an acid or ash diet).

Then along came a study in May, 2009, which by the way was a rather rigorous one, that concluded high protein intake was just fine for bones, regardless of where the protein came from. High vegetable intake was not more helpful than high protein intake from eating meats (5).

So much for the supposed evils of being a carnivore.

Then to add insult to vegetarian injury, there was a theory that the more alkaline your diet is -- a diet high in vegetables -- the less likely you were to have bad things happen to your bones. The theory stated that eating meats, dairy and grains -- sometimes called an "acid" or "ash" diet, high in phosphates -- resulted in malevolent things happening to bones. Things like osteoporosis and fractures. But just this September that theory (demoted to a "hypothesis") was all shot to heck in a major review of the evidence to date (6).

Two longstanding theories about the beauty of vegetarianism gone, just like that, in five months. Not fair.

However, it should be noted that most vegetarians also eat substantial amounts of grains -- the least acid of the foods studied. Perhaps because of this along with adequate vegetable protein we do not see osteoporosis in vegetarians any more so than in non-vegetarians.

What is true is there are many variables affecting diet and bone health -- and these are just a few of the stories.

Bottom Line: Eat your protein. What kind of protein? It really doesn't matter. I'm happy if you do soy in moderation and love your vegetables. But for bones, just eat your protein. Vegetables are a good thing by every measure from cardiovascular risk to cancer so my preferences lean there. But that's my bias, not the research on osteoporosis.

Strontium

Strontium, one of the most abundant elements on the planet, is almost entirely concentrated in our bones and connective tissue. In bone, it acts to increase density and strength. Strontium in various forms - lactate, carbonate, chloride, gluconate, citrate and in the largest studies to date, as strontium ranelate - has consistently shown not only improvements in bone density but significant reductions in the risk of fractures (7 - 9).

It should not be taken at the same time as calcium as calcium competes for absorption with it in the intestine. Most studies suggest taking strontium at bedtime to avoid this potential problem.

Bottom Line: Strontium may be a more effective and less expensive treatment than the Bisphosphonates such as fosomax, actonel, etc. it may also be superior to just about any other treatment for osteoporosis we have. It not only can help reverse osteoporosis but helps prevent recurrence of fractures in those who already have suffered a fracture due to osteoporosis (10)

Because of these factors, I consider strontium to be a first line therapy for bone loss.

NOTE: There have been rare reports of skin rash and reversible liver damage with strontium ranelate. This is the same syndrome seen in those who have a sensitivity to any medication. But if you are taking strontium in any form, you should discontinue it and contact your doctor immediately if any fever with skin rash or swollen glands develops.

Vitamin K

Who would have thought this vitamin could be safely taken in high doses to not only improve the strength of bone, but significantly reduce the incidence of fractures? I certainly didn't. And even more remarkably, vitamin K seems to do this without consistently increasing bone density or reducing bone breakdown. That's right. Vitamin K does not increase bone density. Yet it significantly reduces the risk of a fracture (11).

Another finding is that Vitamin K may also reduce the development of cancers in a study of over 400 women with osteoporosis (12).

But, you may ask, doesn't vitamin K cause blood clots? Even though it helps prevent fractures, aren't we increasing our risk of a blood clot forming by taking high dose K?

Actually, NO. You do not increase clotting risk with these doses of K unless you are taking Coumadin. Which most of us are not.

High doses of K - 5 mg per day for four years -- has been studied without any increased risk of clotting or toxicity.

BUT DO NOT TAKE VITAMIN K IF YOU ARE TAKING COUMADIN. ONLY IN THIS SETTING WILL IT CAUSE A PROBLEM AS IT INTERFERES WITH THIS DRUG'S ACTIONS.

Bottom Line: Vitamin K can be safely taken at doses greater than 1 mg per day to help reduce the risk of fracture for those with osteoporosis. It is an essential part of our osteoporosis treatment and fracture prevention program.

Alcohol

I am very partial to a good Bloody Mary as well as a Cadillac Marguerita. Besides defining myself as a real lightweight when it comes to drinking, it also raises the question of alcohol as a risk factor for osteo and fractures. Am I increasing my risk, even by a little, to drink on occasion?

Well, 2 large studies have examined this closely. Results? Moderate drinking -- defined as one or two drinks per day -- does not increase one's risk of osteoporosis or fracture -- at least not in men. More than this, however, can significantly increase a man's risks.

And by the way, a drink is defined as one shot of alcohol, not a glassful, sorry to say. Or one to two beers is also OK.

But in women, more than one drink may actually be helpful. More than a few drinks, you say? Yup. Women may actually increase their bone density by drinking more than two drinks per day (13-14). Of course, by doing so, a woman would also increase her risks of breast cancer, most other cancers, liver disease, cognitive decline and hypertension. So, heavy drinking for women to help bones? Maybe not such a good idea (15).

Bottom Line: All things in moderation may make Jack and Jill a very dull couple, but they sure do have good bones. Take it easy on the libations and you can have your drink without a worry about your skeletal welfare.

Fish Oils

Last and certainly not least is the question as to whether fish oils have any impact whatsoever on bone support and prevention of fractures. And the answer is they definitely have an effect.

We're just not sure what it is.

We have a number of studies which show fish oils are great for mice and rats. They help their bones stay real strong. And in people there is some evidence it protects against osteo. But so far, nothing which is clearly convincing (16 - 17).

Now, having said that, consider this. Diets which are higher in fish oils (omega-3's) result in:

Decreased risk of heart disease and sudden death

Decreased risks of cancers

Lower risk of death from all cause

Reduced inflammation with rheumatoid arthritis

Reduced severity of asthma (18 - 20)

So what's not to like? True, we don't have the exact doses down for fish oils, but the evidence is strong that they are really helpful for many inflammatory conditions.

Bottom Line: take your fish oil. It's good for you. And see your health care practitioner to guide your best usage of this. In my practice, most patients with the diseases noted above -- including osteoporosis -- are taking at least 2 grams a day of omega 3 fish oil. This, by the way, is pharmaceutical grade, screened for peroxides, mercury and other metals, really pure stuff.

CAVEAT: DO NOT TAKE FISH OILS IF YOU ARE ON ANY BLOOD THINNER. OR WITHIN 2 WEEKS OF ANY PLANNED SURGERY. OR IF YOUR DOCTOR ADVISES YOU NOT TO TAKE.

There you have it. The pearls I know today.

Bottom line is you should always check with your health care provider on issues as important as your bone health. But don't be afraid to have that discussion with what you have learned here.
With my best wishes for your health!

Joseph Sciabbarrasi, M.D., has practiced Integrative Medicine in West Los Angeles since 1993. In addition to his work with Osteoporosis, Bioidentical hormone replacement therapy, Cardiovascular and Chelation therapies, he also lectures, writes and celebrates his weekends with his wife, Kathleen and their 8 year old son, Kieran. Join him at his website:
www.drjosephmd.com

References

1. New SA. Do vegetarians have a normal bone mass? Osteoporos Int. 2004 Sep;15(9):679-88. Epub 2004 Jul 16.

2. Ho-Pham LT, et al. Effect of vegetarian diets on bone mineral density: a Bayesian meta-analysis. Am J Clin Nutr. 2009 Oct;90(4):943-50. Epub 2009 Jul 1.

3. Lydeking-Olsen E, et al. Soymilk or progesterone for prevention of bone loss--a 2 year randomized, placebo-controlled trial. Eur J Nutr. 2004 Aug;43(4):246-57. Epub 2004 Apr 14.

4. Frassetto LA, et al. Worldwide incidence of hip fracture in elderly women: relation to consumption of animal and vegetable foods. J Gerontol A Biol Sci Med Sci. 2000 Oct;55(10):M585-92.

5. Fenton TR, et al. Meta-Analysis of the Effect of the Acid-Ash Hypothesis of Osteoporosis on Calcium Balance. J Bone Miner Res. 2009 May 6.

6. Fenton TR, et al. Phosphate decreases urine calcium and increases calcium balance: a meta-analysis of the osteoporosis acid-ash diet hypothesis. Nutr J. 2009 Sep 15;8:41.
7. Meunier PJ, et al. Strontium ranelate: dose-dependent effects in established postmenopausal vertebral osteoporosis--a 2-year randomized placebo controlled trial. J Clin Endocrinol Metab. 2002 May;87(5):2060-6.

8. O'Donnell S, et al. Strontium ranelate for preventing and treating postmenopausal osteoporosis. Cochrane Database Syst Rev. 2006 Jul 19;3:CD005326.

9. Reginster JY, et al. Long-term treatment of postmenopausal osteoporosis with strontium ranelate: results at 8 years. Bone. 2009 Dec;45(6):1059-64. Epub 2009 Aug 11.

10. Hiligsmann M, et al. Cost-effectiveness of strontium ranelate versus risedronate in the treatment of postmenopausal osteoporotic women aged over 75 years. Bone. 2009 Aug 28.

11. Cheung AM, et al. Vitamin K supplementation in postmenopausal women with osteopenia (ECKO trial): a randomized controlled trial. PLoS Med. 2008 Oct 14;5(10):e196.

12. Braam LA, et al. Vitamin K1 supplementation retards bone loss in postmenopausal women between 50 and 60 years of age. Calcif Tissue Int. 2003 Jul;73(1):21-6.

13. Kanis JA, et al. Alcohol intake as a risk factor for fracture. Osteoporos Int. 2005 Jul;16(7):737-42. Epub 2004 Sep 29.

14. Tucker KL, et al. Effects of beer, wine, and liquor intakes on bone mineral density in older men and women. Am J Clin Nutr. 2009 Apr;89(4):1188-96. Epub 2009 Feb 25.

15. Salynn Boyles. Alcohol Linked to Cancer Risk in Women - Study Shows Even Low-to-Moderate Drinking Raises Risk of Cancer. WebMD Health News.

16. Fernandes G, et al. Effects of n-3 fatty acids on autoimmunity and osteoporosis. Front Biosci. 2008 May 1;13:4015-20.

17. Salari P, et al. A systematic review of the impact of n-3 fatty acids in bone health and osteoporosis. Med Sci Monit. 2008 Mar;14(3):RA37-44.

18. Mozaffarian D. Fish and n-3 fatty acids for the prevention of fatal coronary heart disease and sudden cardiac death. Am J Clin Nutr. 2008 Jun;87(6):1991S-6S.

19. Iglesias del Sol A, et al. [Health effects of fish oil and fish oil supplements: consumption advice sustained]. Ned Tijdschr Geneeskd. 2006 Sep 23;150(38):2069-71.

20. Simopoulos AP. The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Exp Biol Med (Maywood). 2008 Jun;233(6):674-88. Epub 2008 Apr 11.

John Lundberg: A Big Win For Experimental Poetry

2009-11-22T12:00:00Z

If you read a review of Keith Waldrop's "Transcendental Studies: A Trilogy," this year's winner of the National Book Award for Poetry, there's a good chance it will include the word "postmodern" or "avant-garde." These are terms that put a lot of readers on guard, signaling experimental verse. And it only takes a glance at "Transcendental Studies" to see that Waldrop's poetry isn't the sort that will ever turn up in a hallmark card.

In an interview with the website The Jivin' Ladybug (we really are in avant-garde territory here) Waldrop suggested that poetry is "having nothing to say and saying it," explaining, "In my work you could find statements here and there. It isn't what I'm writing for. What I'm after is closer to music than to philosophy or information in that sense." And that aim can be confusing for a reader expecting a poem to make sense in a more traditional manner. Waldrop addressed the issue:

What I write down is a kind of script for something that sounds. I find people often don't read it that way. They have a hard time translating from lines on a page to. . .part of this is the way poetry is taught in schools and such. You get a poem and you're supposed to figure out what it means. Once you know what it means, you throw the poem away because you have the meaning. That is the destruction of poetry. I want the words to remain and if people don't know the meaning of them I don't think that's as bad as losing the sound.

Waldrop's methods of composition are also, at times, unorthodox. He employed a collage technique to create "Transcendental Studies" --building poems, in part, by combining phrases from other works. Waldrop has explained the process as "a way to explore, not necessarily the thing I am tearing up, but the thing I am contriving to build out of torn pieces." He described his method for composing part of "Transcendental Studies" in an interview to the National Book Foundation:

I put three books in front of me, all prose, a novel, then something psychological, then whatever I happened to have around. I would take phrases from these three books and make some stanzas, four, five six lines. Once I had that I'd make more stanzas of the same number of lines, and when that gave out, after a page or two, I'd say alright I have this poem now and I would take it to the typewriter and type it up and in doing so I would rearrange the stanzas alphabetically.

Alphabetizing stanzas after writing them may seem oddly arbitrary, but the process was important to Waldrop. When a portion of "Transcendental Studies" was translated into French, he instructed the translator to rearrange the stanzas alphabetically after translation--leading to poems that differ considerably from their English counterparts.

What sorts of poems do Waldrop's unorthodox poetics produce? Here a few excerpts from the book

Balancing. Austere. Life-
less. I have tried to keep
context from claiming you.

Without doors. And there are
windows. How far, how
far into the desert have we come?

Rude instruments, product
of my garden. Might also be
different, what I am thinking of.

So you see: it is
not symmetrical, dark
red out of the snow.

Enemies for therapy, the
rind of the lime tree
in elaborate garlands.

Strew the table. Let the hall
be garlanded and lit, the will
to break away. Welcome your couches.

Witness these details. Your judgment, my
inclination. Hear. Touch. Taste.
Translate. Fixed: the river.

Disquieting thought, I am not
ultimate, full moon, memory.
Prepare for rout.

Here, even, in the
sand. Among the rocks, I have
heard, remnant of a cloud.

Unfleshed, short, thin, pointed.
Independent of you, a
revelation. A great city.

Flatly unknown, you do not
know of yourself, do not know
yourself, not stuck full of nails.

Under such illumination, darkness
becomes terror. Under this high
wall, dark ground.

Long before this week's award, the poet Michael Palmer called Waldrop one of the vital and requisite, semi-secret presences in American letters." His wife Rosmarie, also an accomplished poet, said in the Ladybug interview, "We haven't gotten so much attention that it got to be a bother. We don't have that problem." Let's hope it isn't a problem, because they're going to be getting a lot of attention now.

Keith Waldrop currently teaches at Brown University and edits Burning Deck Press along with his wife.

Michael B. Laskoff: Glenn Beck for Governor

2009-11-22T02:42:59Z

I first became aware of Glenn Beck in a sort of backhanded way. He was already well on his way to capturing the hearts of conservative America with his nationally syndicated radio show, but not yet a pillar of Fox News. At the time, I was working on a book about business leaders with ADHD (ADD), and a friend directed me to an interview that Beck had recorded with Ty Pennington, host of Extreme Home Makeover.

As I learned, both have ADHD and take medication to help manage the condition. As someone with the condition, who also takes Vyvanse (an ADHD medication), and was writing a book, I was quite excited to hear the interview. I actually contacted Beck's office in the hopes of interviewing him, but sadly he declined.

Since then, Beck has become a celebrity and the source of much personal conflict for me. On the one hand, he's a legitimate, 'out' ADHD role model. We don't have too many. In addition, the condition seems to contribute heavily to his success. Love him or hate him, you've got admit that he's well spoken, highly creative and superbly entertaining. (These are traits commonly associated with the condition.) On the other, I passionately disagree with his politics and demagoguery. He's flip-flopped more times than The Daily Show can mock and happily peddles his right wing fantasies as if they were actually facts. Truly, it scares me that people take him so seriously.

Today, I learned that Beck wants to transcend the stage and mobilize his political 'base.' That's fine, but I would suggest that now is not the time for half steps. If he thinks that his ideas are so compelling, I'd urge Beck to follow in the footsteps of Jesse Ventura and run for governor. In other words, put his money where his mouth is. Fortunately, New York Republicans don't have a credible candidate for governor in 2010, so Beck should have no trouble clinching the ticket without having to be a spoiler.

Should he take such a step, I will happily donate to the campaign, and my respect for Beck would increase enormously. Of course, I wouldn't want him to win, and if he did, I think that my home state would be worse for it. My only consolation would be knowing that New York has its first openly ADHD governor. For me, that would actually be a big deal.

Pavel Somov, Ph.D.: Cultivating a Healthy Relationship with Time

2009-11-22T01:50:55Z

Being Means Being in Time

A sense of being involves a degree of separateness from the rest of the world. After all, the verb "to exist" literally means to stand out. When you are present, your awareness of your own existence happens against the backdrop of time. Recall that time is really just perception of change, of processes, of movement, of information flow. So, to be, we have to experience ourselves as apart from all this flow. Being is a contrast between our subjective permanence and the objective impermanence of everything that is around us, between our (subjective) timelessness and the constant timing (changing) of reality outside of us. Like stillness, being exists in contrast with movement. When we experience ourselves, there is a feeling that while we are fundamentally the same from a moment to moment, the world outside of us is changing. We begin to be. We feel reborn. We pop out of the incessant stream of associative and conditioned thinking and mindless behavior. We reconnect with that immutable sense of am-ness. No longer lost in the world, we begin to experience ourselves in a relationship with it. We begin to register the experience. We remember that we are alive. We feel glad that we woke up and marvel at how time has slipped away. Thus, to be, we have to slow down enough to notice ourselves being in time.

Mindlessness Is a Lapse of Time

How often have you looked back at the past week and couldn't remember it? Sure, you can look through your daily planner and even come up with an alibi if you needed to. But don't all these memories seem void of that first-person experience of being there? It's as if you know you did this or that, but you don't have the memory of experiencing it. Mindlessness is a time lapse.

Timefulness of Mindfulness

The author James Austin, a neurologist, contrasts ordinary sitting with sitting in mediation (zazen). He notes that "ordinary" sitting, in retrospect, "shrinks the estimate of time." "[T]hirty seconds of real time contract so that they seem to last only twenty six seconds," whereas "during zazen, meditators tend to expand their estimates of time ... thirty seconds of real time now seem to last thirty seven seconds" (2001, 563). Why would that be? Meditators, unlike "ordinary" sitters, sit in a state of mindful observation of what is, paying attention, encoding more experience and thus getting more life out of the same thirty seconds than the rest of us. The more experience you pack into a period of time, the longer the period of time feels when you look back at it. Mindfulness is, thus, timefulness.

Timelessness of Mindfulness

Mindfulness is also timelessness. After you spend a whole day in mindless frenzy and look back, it feels like time slipped through your fingers. But while you are moving through this frenzied day, you are constantly checking time, racing and waiting, racing and waiting (on the kettle to boil, on the kids to get dressed, on the car in front of you to turn). This is the experience of time in the rat race: while you're in it, time races and drags; and when you look back, you wonder where the time has gone. If you are approaching the day with attention, mindfulness, and presence, you feel timeless as you move through your day. Timelessness isn't when time stops. Timelessness is when you stop paying attention to time. When you're mindfully engaged in reality, you ignore time; you are just doing what you're doing. And when you look back at the day, you see a long fruitful span of meaning and presence, full of encoded experiences. That's what I call a healthy relationship with time.

Pavel Somov, Ph.D. is the author of "Eating the Moment" (New Harbinger, 2008), "Present Perfect" (NH, 2010), and "The Lotus Effect" (NH, 2010). He is in private practice in Pittsburgh, PA. For more information visit www.eatingthemoment.com and sign up for Pavel Somov's monthly "Mindful-not-Mouthful" Newsletter

Lee Schneider: Spitting Into The Future

2009-11-21T16:17:00Z

It's been said that the future will be much like the present, only longer. But knowing the future would change your life. If you knew the exact location of your death you might avoid that place and buy a few more years. ("No, I can't go to the Teacups ride at Disneyland ever again and I can't tell you why.")

A time machine is one option, and there are instructions for building one to be found on the web. In fact, experts like Dr. J. Richard Gott of Princeton University say that we already know how to travel into the future. All you have to do is travel really fast. "If you accelerated to 99.995 percent the speed of light five hundred light years away and then come back at the same speed, the Earth will be a thousand years older, but you've only aged 10 years," says the doctor. Easy enough.

Richard Branson is working on a spaceship for space tourists - maybe I'll hitch a ride with him. The price of a ticket is only $200,000.

There's a cheaper way to know the future and it involves popping a little bit of your spit in the mail. That's right - you send in $399 along with a spit sample to a company called 23andMe. They analyze your DNA and tell you your genetic predisposition to certain diseases. You'd know whether you're at risk for breast cancer or prostate cancer, Type 2 Diabetes, Crohn's Disease, Parkinson's, Restless Legs Syndrome, Macular Degeneration - 118 diseases in all. You might even find out some fun stuff from your past, like the guy you call Dad is not really your father.

Oh, the folks at 23andMe could make a mistake. Genetic testing is not infallible. You can get false positives. Genetic testing is also not a death sentence. Just because you have a predisposition to a disease doesn't mean you'll get it. Diet, lifestyle, environment - lots of factors to consider. Since scientists are still learning more about DNA the results of your test could be re-interpreted at a later date.

("Honey, great news - the doctor said I should eat more deep-fried Twinkies!") The 23andMe folks even have a sense of humor about it all, with a blog titled The Spittoon, and a blog subtitle of "more than you've come to expectorate."

I'm laughing, until I start thinking. What if everyone did this? Who gets access? Insurance companies could check out your pre-existing conditions even before they existed and find new ways to deny you coverage. Marriages would end before they started. Schools could deny scholarships because they wouldn't want to waste money on you. ("But Van Gogh died at 37! I have plenty of time to paint a masterpiece.")

Not knowing the future might, paradoxically, give us more power over what's next in our lives. I think I'd rather take my chances with destiny's roulette wheel.

Anne Naylor: 8 Gateways To Greater Happiness

2009-11-21T12:00:00Z

Are you as happy as you would like to be? Or could you be happier? These weeks leading up to the end of the year holidays can for many be an emotional roller coaster.

A gateway presents itself as a choice. You go up to it. Then you decide: Do I go through it?

My last 50 weeks of HuffPost articles have offered several themes relating to happiness. Happiness grows from a state of mind -- a perspective about life and your engagement with it, and the actions you take to support your happiness.

The following 8 Gateways include links to previous posts for a happier and more rewarding life.

1. Act gratefully ...
.... be thankful

Having a sense of gratitude is the foundation of a happy life. Being thankful has a way of communicating itself to others, sending a wave of happiness out into your world, which has a way of coming back to you.

10 Ways To Get More Energy By Being Thankful

Think of all the beauty that's still left in and around you and be happy!
Anne Frank

2. Do what you really love to do ...
... be true to yourself

Do you know what you do that makes you happy? Do more of it. Perhaps you have been a person who has tried to please others and conform to their notion of how to live a happy life.

You may march to the beat of another drummer. Fulfilment and happiness will come from honouring what is true for you. Your unique strengths are the aptitudes, gifts and talents with which you were born.

3 Tips To Awaken Your Life's Passion

The Constitution only gives people the right to pursue happiness.
You have to catch it yourself.
Ben Franklin

3. Connect with today's opportunities for happiness ...
... be open for a new day to dawn with fresh hope and inspiration

Each day holds the possibility for joy. On a scale of 1 to 10, where 1 is low and 10 high, how do you rate your happiness now? If it is low, imagine turning the dial up and choose a higher level. What if when you start your day, you choose 9 on your dial. Try it and see what happens.

8 Ways To Connect For Greater Happiness

The really happy person is one who can enjoy the scenery when on a detour.
Unknown

4. Act on your agreements and commitments ...
... be complete

One of the keys in the post below has to do with clearing out deadwood, handling the agreements you have made so that they do not literally drag you down.

You know the kind of thing, you keep passing by the light bulb that needs changing. Or you keep meaning to clear out the garage. Or make an appointment with the optician. Or take the old clothes to the goodwill store.

Try dedicating half a day to completing some of those commitments. The chances are that you will feel very happy that you did.

3 Keys to Higher Love And Restoring Happiness

The essentials to happiness are something to love, something to do,
and something to hope for.
William Blake

5. Resolve old hurts, caused or received ...
... be forgiving

Holding on to old hurts you have either inflicted (guilt or shame) or received (anger or resentment) can create a cloud of unhappiness around you.

Reconcile yourself to past pain, let it go and move on. Forgiveness is a process. It does not necessarily happen overnight. But it is within your control to choose to forgive; to be someone who is for-giving, both to yourself and others

How To Forgive - And Be Happy Now

He is happiest, be he king or peasant, who finds peace in his home.
Johann von Goethe

6. Contribute your talents, time and energy ...
... be giving

Doing the most mundane tasks, such as stuffing envelopes, takes a weight off the organizer of a non-profit and can be a delightful time to hang out with others. No brain power required. Such activities can be therapeutic while they are useful.

What about a talent you love to use: painting and decorating, sewing or knitting, fundraising, acting, design, singing. To give freely what you love, while others benefit, expands your happiness.

How To Increase Your Joy Through Service

All who would win joy, must share it; happiness was born a twin.
Lord Byron

7. Have fun ...
... be creative with the gift of your life

When times are tough, it may not always seem like it, but imagine your life is truly a gift. Use your imagination to be playful, to create the best your life can be in every circumstance.

5 Creative Ways To Pursue Your Passion

To live happily is an inward power of the soul.
Aristotle

8. Get to know who you truly are ...
... be trusting

Your human spirit is remarkable beyond words. Who you are is indefinably connected with everyone else, and so is never abandoned. Our world is extraordinary, beautiful and blessed. Regular meditation can assist you to see it this way, and to trust in the process of life unfolding more perfectly than you could ever imagine. Be happy with just who you are.

12 Simple Steps To Meditate For Relaxation

There is no way to happiness, happiness is the way.
Buddha

Next week, I am taking a break. I look forward to being with you all again on 5th December. Happy Thanksgiving!

Please feel free to leave a comment below, or contact me at Anne@annenaylor.com

Please re-tweet or pass to friends who may benefit from this post.  For updates on The New Wealth Book, click here: The New Wealth Book Blog The latest: Grow Your Wealth With Health And Happiness.

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Julia Moulden: Top 10 New Radical Gifts

2009-11-21T12:00:00Z

Are you like me -- suddenly realizing that the holidays are only weeks away? And are you totally and completely convinced that you don't want to give the same old, same old this year? Then my favourite New Radical gift ideas might just come in handy. Hopefully you'll find something for the hearts, minds, and souls of the ones you love. (New Radicals are people who are putting the skills they acquired in their careers to work on the world's greatest challenges. For more about the New Radicals, please see archived articles.)

JOY
Let's begin with toys. But not just any toys. The cute and clever ones made by Owi-Robots. Especially the easy-to-assemble 6-in-1 Educational Solar Kit that turns into options like a car, windmill, or puppy. And here's the best part -- because it's solar powered, no batteries are required. Oh, joy!

LOVE
Glove Love, to be specific. The folks at dothegreenthing.com -- a UK-based non-profit that inspires people to live greener lives -- have come up with a way to save the world from single, unwanted gloves. You know, the ones that have been separated from their original partners and end up stuffed in the back of the closet. Glove Love pairs these singles up with new partners, and sells them for a fiver. The video -- with narration by Emma Thompson -- is very funny in a distinctly British way.

PEACE
The pundits are full of woe, because everyone's convinced that the Mid-East peace process is doomed to failure yet again. Show your support for peace by buying a CD from the Middle East Peace Orchestra. It's a collaboration between musicians, all connected to the region, who are on tour playing concerts for peace. Their work is deeply moving, and a treasure trove of music from both Arab and Jewish traditions, created by musicians who are Christians, Jews, and Muslims.

LIGHT
Whoever said it first got it right, the best gifts are the ones that just keep on giving. BringLight.com is my choice for an organization that makes donating money smart and simple. First, 100% of donations go directly to charities. Second, rather than giving to a pool, you choose where your money goes (they have an ever-changing list of options). And you can create a Giving Group to multiply the impact of your contributions. So, if your sister really loves horses, you can donate to an equine rescue effort on her behalf. Marriage equality, prenatal care, young musicians, reptile conservation -- there's a cause for everyone on your list.

WISDOM
Award-winning photographer Michael Forsberg believes that we can save the Great Plains -- the grasslands that stretch across western North America, second only to the Serengeti in size. His new book, America's Lingering Wild, the most gorgeous coffee table book to come along in years, spells out what's wrong and what we can do. Many of the stories in the book were written by Dan O'Brien, author of a number of books about the region. Dan also raises buffalo in South Dakota, a sustainable (and healthier) alternative to beef, which he sells through his company, Wild Idea Buffalo. You can even order a combo -- buffalo steaks and an autographed copy of the book. A feast for all the senses!

COMPASSION
It's the new media equivalent of a book you just can't put down. Katerina Cizek was filmmaker-in-residence at an inner-city hospital and has created a powerful collection of multi-platform documentaries that use storytelling to help drive social change (winning every important international award in the process). Watch what happens when young, homeless mothers pick up the cameras. When film animation students and a suicide prevention group come together. What healthcare providers discover as they support community-based care in Africa. The National Film Board has created a box set of the filmmaker-in-residence project. Get one for your kid's school, for your local hospital, your boss, yourself. And then check out the next project Katerina and the NFB have up their sleeves: HighRise, a multi-platform, multi-year international project about the future of cities, as seen through the lens of the highrise tower.

KINDNESS
Nothing says holiday more than a meal together. I don't know about you, but I think more about my guests and what I'm serving than the table itself. Luckily, Mary Anne Davis of Davis Studio has set me straight -- she sees setting the table as an under-appreciated art form. She talks about the beauty of the table and the relationship between the pieces we choose. Mary Anne is an artist, a potter, and an idealist -- in addition to making gorgeous things, she's made a full commitment to environmental stewardship. Her tableware is durable and timeless. Materials are sourced locally. It's all made in upstate New York. And with the lowest possible footprint. Long been known for her colourful works, Mary Anne has branched into... white! Her new line carries a cheeky name: Naked Dishes. (Oprah's a big fan.)

COMFORT
Icebreaker garments are the Goldilocks of outdoor wear: not too hot, not too cold. I put a cami (the line is made from 100% pure New Zealand wool) through an urban challenge, wearing it under a wrap cotton shirt inside an over-heated office building and on my walk to and from. It performed beautifully, and felt soft and comfortable -- just right, in fact. Icebreaker does more than create great products -- check out their animal welfare policies, ethical manufacturing, design ethos, and corporate culture. And they're fun: every garment comes with a Baacode -- plug the number into Icebreaker's site, and you'll discover which sheep station the wool comes from, and meet the farmers, too. But here's the best part -- unlike synthetic outdoor wear, this stuff doesn't hold body odour. Maybe Saint Nick wears one of these under his suit on that long winter's night?

FAITH
Let's just say that I don't believe in sin. Pleasure, yes. Which is why this list has to include something deep, dark, and delicious from Dark Side Chocolates. These artisans, far from the madding crowd in British Columbia, offer a carefully selected range of tastes, like Lavender-Vanilla and Tequila-Lime. Should you desire, there are even some readings about why chocolate is good for us. But I ask you, does one even need to think about being chaste at this time of year?

HOPE
Social entrepreneurs have given us lots of reasons for hope. How? By creating new models for business that can be picked up by others around the world. Patty Johnson of the North South Project has done this brilliantly. Her company fuses northern design sensibilities with the craftsmanship and traditions of the southern hemisphere (like Botswana, Guyana, India, and Mexico). These are investment pieces or, as I like to think of them, heritage. As in, things you have for a lifetime and pass along to others. Check out the playful (and award-winning) lamp made by the Wai Wai weavers of Guyana. I'm looking for a spot in my home for one... "And one for the shopper" is my motto.

OK, so these are Julia's top 10 picks for the season. But no reason to go all Kanye West on me -- if there's something you think should be on this list, please share your favourites by commenting below. And let the festivities begin!

Julia Moulden is on tour, talking about the New Radicals. She'd be delighted to hear from you. JULIA (that familiar symbol) wearethenewradicals (dot) (COM).

Tara Stiles: Should Insurance Companies Pay For Preventive Care?

2009-11-21T12:00:00Z

Should government pay for preventive care? Should insurance companies? This topic has been coming up lately around the studio. We encourage people to come to class frequently to give them the best possible benefits. The once a week Strala class is fine for relaxation, or a fun social activity, but if you are interested in cultivating a healthy mind and body, more regular practice is necessary.

This brings many people to the problem of managing their already tight budgets. In New York City it tends to break down something like this: Rent, food, insurance, fun. Similar to the fundamental problem of the food diary, we forget to account for mindless spending as well as mindless calories. Clothing and drinks seem most always to get left off the list. I see people complaining on Facebook that they don't have enough money for yoga and in the same message planning to meet their friends out later for drinks.

I do understand what it's like to struggle and be concerned about money. I've been there. I think because of a variety of factors from my childhood leading up to now, I will always feel like I am struggling in some way. That's a whole other cause for stress that leads to sickness. We offer a free (bailout) class once a week at the studio open to anyone. We even offer full and partial scholarships, but in my experience, people don't appreciate what they don't pay for. I'd rather have someone hand the studio $200 cash and we give them back some of it every time they come to class until it's all back in their wallet, than hand out scholarships to someone who heads to the bar or Urban Outfitters after. We're all here together to get healthy and feel good, so we can live our best lives. We want to be surrounded by people cultivating the same for themselves.

It's all where your priorities are. You have to want it for yourself. A regular practice puts you back in touch with you. You don't need all the stuff to be happy.

The question has come up a few times in the studio if insurance companies would cover preventive care. Many companies do, which is fantastic, and smart. Rodale, the publisher of Men's and Women's Health magazines, also publisher of my first book, out Aug 31, 2010, Slim Calm Sexy (shameless self promotion in spirit of HuffPo blogging) reimburses their employees for yoga classes. Other companies have similar policies. A few people I've met at the studio have had strong recommendations by their doctors to practice yoga for specific cases like high blood pressure and vertigo, but as a general practice I really don't think insurance companies and government are there yet.

How would insurance companies make money from healthy people? They wouldn't. Hospitals would be ghost towns. Diabetes and heart disease would become an epidemic of the past. Pharmacies would become dusty and irrelevant. No more need to prescribe anything for anxiety, depression, insomnia or weight loss. Viagra would go out of business because people would be having the best sex of their lives, and if they are too old or not in the mood, they would realize that it's not appropriate to take a pill to get it up. People would make better choices, be happy from the inside out, and actually be nice to each other. People would choose careers that they actually wanted to do, rather than follow a path out of fear of failure, or desire to build protective piles of cash around themselves. People would care about things less and people more.

That reality will never be a decision of insurance companies, or government. That has to be a movement of the people. You have to want it for yourself. You have to be healthy because you want to. Waiting for an outside authority to shine the light for us - whether a doctor, insurance company, or whatever - will never work so well as taking back our responsibility and making our own choices. We all have to find our own way and there are people that can help you along the way to get there. Just look around.

Marc Lesser: Doing Less Means More Productivity, Kindness & Love

2009-11-20T23:05:57Z

When my two children were in elementary school, a weekly day of doing less was an important part of our family ritual. We borrowed some ideas from the Jewish Sabbath as well as Buddhist Day of Mindfulness practices. At the heart of our day we had three simple rules that we applied from sundown on Friday until sundown on Saturday evening:

Rule #1: There was no spending money.

Rule #2: There was no watching television.

Rule #3: We did something together as a family.

These three guidelines produced significant results in the quality of those twenty-four hours. What a relief to not buy anything, not have the television on, and spend time simply enjoying each other's presence. My wife and I talked more with our two children; we read books, told stories, played games, went for walks, and shared meals. The biggest benefit of this structured break was that, for a day, the pace of our lives slowed down and our family connections increased.

One of my favorite parts of this ritual was the formal ending. We observed the Jewish tradition of looking for the first three stars to become visible on Saturday evening, signaling that Sabbath was over. It was fun and exciting for the four of us to stand on our deck together, seeing who could find the three stars as the sun faded and nighttime slowly emerged. Of course, since we live in Marin County, dense fog sometimes forced us to use our imaginations.

Instituting rest and simplicity is not a magic wand for perfection. There were occasional disagreements, grumpiness, and boredom. But our imperfections often emerge as the most endearing parts of ourselves, and those "Sabbath" days stand out as important building blocks, and are great memories, for our still-growing family.

I'm a big proponent of doing less, and at times even of doing nothing. Nearly every morning for the past 35 years I've spent about 30 minutes, doing nothing; nothing but being aware of my breath and body, and occasionally just appreciating being here, being alive. I also like to spend whole days, about once a month, in the practice of doing nothing, and once a year spend six or seven days, again, nothing. I often suggest to my coaching clients, busy executives and non-profit leaders, to take the time, right in the midst of their busy, hectic workdays to do nothing - nothing but being aware of the breath; just noticing, I'm alive; I'm here. It seems to result in more calm, more productivity, and more effectiveness during the rest of the day.

The art of doing less isn't merely about becoming more productive employees or businesspeople. The true benefit of focusing on and taking a break from busyness is that it brings more kindness and love into our lives. With less busyness and unnecessary effort, more kindness and love can rise to the surface, leading to more effectiveness, energy, and focus. When we feel depleted, love is the best replenisher -- which includes the love we feel for ourselves, the love we freely give to others, and the love that comes to us from the people we care for and admire most.

It's worth pointing out that the opposite seems to be true as well. In our increasingly busy and impatient world, people seem to be less kind and patient with each other. Much of that seems to stem from busyness itself and from the increasing attitude that being polite and caring is just another form of wasting time.

When we do less and begin to unravel many of the motivations, worries, and strivings that make us run in circles -- and when we stop trying to second-guess everyone else's motivations, worries, and strivings -- what we find at the very core of self and of life, I believe, is kindness and love. Those two glorious things are the most profound levers for accomplishing more.

This is not a radical idea. And yet, what a radical idea! What a radical way to live your life! It underpins the best of psychological, spiritual, and contemplative practice. It is the fundamental teaching of all great mystics and is the experience most of us hold deepest in our hearts. We glimpse this basic truth whenever we touch birth or touch death and experience a complete acceptance of the simplicity and sacredness of being human. The more you quiet your mind and let go of striving -- which is all too often someone else's concept of striving imposed on you -- the less you have to "do" and, somehow miraculously, the more that love springs forth from you. I believe that this simple formula is central to being a functioning, happy, and truly contributing human being.

Still, doing less takes courage. Stopping, pausing, reflecting, and fully doing one thing can be much more difficult than reflexively reacting and distracting yourself from what is most essential, most heartfelt, and most needed in your life.

Ramon Resa, MD: Flee the Toxic Parents, the Toxic Environment (Why shouldn't children divorce their parents?)

2009-11-20T22:52:53Z

Danny, a sixteen-year old, came into my office exhibiting signs of depression. No wonder, his mother had just fled the household to escape her abusive husband. In this situation, it seemed Danny ought to make an escape as well. He, unfortunately, felt trapped in a "toxic" environment, tied to his family through blood, if not through love.

Danny's situation reminded me of a recent New York Times article by Richard Friedman. In the article, Dr. Friedman expounded upon one of life's great injustices: that mere strands of DNA, to a large degree, determine whether one is born a king or a peasant, rich or poor, into a loving family or... into a "toxic" one.

Although through his writing, Dr. Friedman describes an example of toxicity that transcends class, dysfunctional parenting resides largely within the realm of minority households and in those lacking higher education. Generation after generation, it rears its ugly head, as each acquires toxic characteristics from that preceding. The children develop issues with self-esteem, and many succumb to depression.

Parents in these families are selfish. They use and abuse their children. They put their children to work and expect them to provide for the family. They smother their children's individual goals and aspirations beneath feelings of guilt. To the parents, education is a waste of time. They would rather their kids take on low-paying jobs so as "not to be a burden on the family" than go to school. Anything else, they believe, is selfish. I was born into one of these toxic families. I can tell you firsthand that it is dangerous, depressing, and stifling.

CNN recently produced a special on "Latinos in America." In one example profile, a young high school student by the name of Christina was having trouble keeping up with her classes, but she had vowed to catch up and graduate with her peers by going to make-up classes on weekends and during the summer. She did not make it to graduation. Her mother insisted that she help in their small store, care for her younger siblings, and care for her 16 year old sister's daughter. In the Latin culture, helping the family is paramount and expected, even if you must sacrifice. This is one of the major causes of Latina teen-aged pregnancy and high drop-out rates from high school.

In his article, Dr. Friedman examined these types of situations and asked why we can divorce spouses but cannot divorce family members. Although in Christina's case, perhaps complete separation would be less advisable than simply refusing exorbitant demands, Dr. Friedman raises a good question, in general.

Sometimes parents do not love their children. Sometimes, like in Danny's case, they are abusive and cruel. These children have every right to divorce their parents, to escape a personal Hell. Many of my family members have run from abusive spouses. Danny's mother escaped from an abusive spouse. Why can't the children do the same?

In part, kids in toxic environments have a harder time reconciling to themselves that their parents do not love them. They even feel guilt about their own feelings of hate, trained by society and religion that they must love their parents unconditionally, but then they wonder: why do their parents not love them? Some parents are just hurtful. Often their parents' parents were hurtful.

Children have also never known anything but their parents and their family. Spouses meet late in life, and they can divorce soon after. Children in toxic family environments have been in that environment for their entire life. It is much harder just to cut themselves loose from it.

Nevertheless, in some situations, they really should! Even if their parents are not physically abusive, they can be toxic through being unsupportive and uncaring. The lack of emotional attachment, of love, can be just as destructive to the psyche of a child as is physical abuse.

Danny found a new home, staying with a friend, and he is now attending community college. I believe he made the right choice. I made a similar one.

In my senior year of high school, I moved out of my home. My grandparents were putting me under tremendous pressure to get a job to help support the family, but I wanted to attend college and further my own educational and career goals. For that, I was considered ungrateful, and it took me many years to overcome the guilt. Of course, in the end, it paid off. My grandparents were able to see what I had made of myself, and I was able to forgive and be forgiven. The most important aspect of my breaking away, however, was the opportunity and foundation I was able to pass on to my own children... and their children to come.

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