The Smart Woman’s Guide to Midlife and Beyond

The Smart Woman’s Guide to Midlife and Beyond
by Dr. Janet Horn and Dr. Robin Miller

Women understand that taking care of their health is essential to maintaining an active lifestyle. This comprehensive guide shows you how to work with your body instead of against it to stay healthy and happy through menopause and beyond. Written by two practicing doctors who have been close girlfriends since they met during medical training at the Johns Hopkins Hospital, The Smart Woman’s Guide to Midlife and Beyond includes the doctors’ own personal experiences, patient stories from their medical practices, and all the information you need to age with good health, grace, and humor.
Includes the information you need to:

  • Care for your whole body to prevent common diseases
  • Learn which health issues are normal, which are serious, and what to do about them
  • Overcome memory loss, depression, and anxiety
  • Understand menopause and hormone replacement therapy
  • Nourish and protect your skin and hair
  • Choose the right vitamin supplements for you
  • Find out whether or not treatments like massage and acupuncture will work for you
  • Know when to share your concerns with your doctor or healthcare practitioner
  • Create a personal Health Maintenance Schedule to keep your health on track

Fish Oil – What Every Midlife Woman (and Man) Should Know
by Robin H. Miller, M.D.

One cannot read a newspaper or listen to the radio or TV without fish oil being mentioned. What, exactly, is it? Why all the hype now? Is it really as good as it’s cracked up to be? All are important questions; you need to know the answers if you want to stay healthy in midlife and beyond.

What is it?
The healthy substances in fish oil are known as the omega 3 fatty acids. Although the highest concentration of these is found in fish, you can also find omega 3 fatty acids in other foods such as flax seed, walnuts and canola oil.

Why all the hype now?
Nutritionists and those in the alternative health community have understood the value of omega 3 fatty acids found in fish for years. Now that the use and value of fish oil has been extensively studied by mainstream medical institutions, more and more physicians are recommending it for their patients.

Is it really as good as it’s cracked up to be?
The American Heart Association thinks so. They recommend that people consume omega-3 fatty acids from fish and plant sources to protect their hearts. Studies have found that omega-3 fatty acids do the following:

  • Decrease the risk of sudden death (from heart disease) and abnormal heart rhythms
  • Decrease the development of atherosclerosis and plaque formation
  • Decrease blood clots
  • Improve the overall health of the body’s arteries
  • Lower triglyceride ( a type of lipid or cholesterol ) levels in the blood

What else is fish oil good for?
Fish oil has been found to be of benefit in stroke prevention, Crohn’s disease, lupus, prostate cancer, colon cancer, high blood pressure and rheumatoid arthritis. Interestingly, a recent study done in England found that pregnant women who consumed 2-3 servings of fish or seafood a week throughout their pregnancy had children with higher IQ’s than those pregnant women who consumed no fish or seafood.

How should you be getting your omega-3 fatt y acids? Is there a difference between fish and other sources?
There are different types of omega-3 fatty acids. The active forms, found exclusively in fish, are called eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Those fish that are highly recommended include herring, sardines, wild salmon and fresh tuna. It is important to note: Farm raised salmon also contain omega 3 fatty acids. However, many of these fish are treated with antibiotics, have been genetically modified, and/or have been fed fish pellets with dye to give them a pink color. Canned salmon, which is packed in the juices of the salmon and contains bones – a great source of calcium – is usually made from wild salmon, and thus, may be a better option than fresh farm raised salmon. Canned tuna can contain a fair amount of mercury, and the levels can be quite variable.

Another form of the omega-3 fatty acids can be found in plants. Flaxseed and flaxseed oil contain alpha-linolenic acid (ALA), which is converted by the liver to the active forms, EPA and DHA. Since the conversion to the active components can vary from person to person, fish oil is a far more potent form of omega-3 fatty acids. It is best to use both fish and flax seed to get omega-3 fatty acids.

If you are interested in taking fish oil as a supplement, look for brands that are distilled and that test for contaminants. Taking it as a contaminant-free supplement will avoid the problem of being exposed to mercury from fish. There are a couple of common brands that do this, Nordic Naturals and Eskimo Oil.
Here is an important tip: If you have fish oil capsules, and, after piercing, it smells like rotten fish, it is time to find a new bottle. Rancid oil isn’t good for you.

Eating fish is probably the best route for getting omega-3 fatty acids. It is always best to get nutrients from whole food.

What about mercury?
There is the potential for fish oil and, of course, fish to contain mercury. Mercury can be toxic to the nervous system and is particularly harmful to the developing nervous systems of babies and small children. Because they may contain too much mercury, there are certain types of fish to avoid or eat sparingly. These include: shark, swordfish, king mackerel and tilefish.

Are there other risks?
Those with bleeding problems should probably avoid fish oil since it thins the blood. Those on blood thinners need to let their healthcare providers know that they are regularly getting fish oil in their diets or taking a supplement so that their bleeding time can be monitored. Some people become nauseated after taking it. Some who take it might find it elevates their LDL cholesterol slightly. Quality issues with fish oil supplements are huge. It is really important to find a good, mercury-free brand as mentioned above.

What is the recommended dose?
There really isn’t a set recommended dose. Fish oil supplements in the amount of 2-4 grams a day have been found to lower triglyceride levels in the blood. Most doctors recommend anywhere from 1-3 grams of fish oil a day. For those patients with high triglycerides the recommendation is 2-4 grams a day.

If you are interested in taking fish oil supplements it is really important to discuss it with your doctor or health care provider first. One more tip, if you find you are burping up fish after you take your supplement, switch to a different brand. There are many, which don’t give you a fishy after-taste!!

The Bottom Line? The hype about fish oil is well-deserved. It can help you stay healthy in midlife and beyond.

About the authors
Dr. Janet Horn is Board Certified in Internal Medicine and Infectious Diseases, with training in Obstetrics and Gynecology. She spent many years on the fulltime faculty of the Johns Hopkins University School of Medicine, where she published articles in medical journals on her research interests, including sexually transmitted diseases, AIDS, and women’s health. She started her solo private practice in 1990 while continuing to teach as an Associate Professor of Medicine on the part time faculty at Hopkins. She has been selected by Baltimore Magazine as one of the “Top Doctors in Baltimore” and by the Maryland Daily Record as one of the “Top 100 Women in Maryland.”

Dr. Robin Miller, in addition to being an experienced Board Certified Internist, is also an Integrative Medicine specialist, having trained with Dr. Andrew Weil as a Fellow at the University of Arizona. She is the founder and medical director of Triune Integrative Medicine, an innovative medical clinic in Medford, Oregon. She is an award winning medical correspondent on regional and national television, radio, and the internet. She is an award winning medical correspondent on regional and national television, radio, and the internet, the author of a health book for children, Kids Ask the Doctor, and a board member of The National Association of Medical Communicators, a society of medical journalists in all media.

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