Monthly Archives: September 2013

Positivity and cancer.

This article should give us all food for thought. Doctors are confronted frequently by having to tell people some very bad news. Counselling and discussion has to go with it, and thought in how best to impart the news. Never easy.

9 April 2013, 2.33pm AEST

Monday’s medical myth: you can think yourself better

Of all the cultural beliefs about health and illness that saturate the developed world, there is none so pervasive and deeply held as the idea that you can “battle” an illness by sheer force of will. We admire people like AFL great Jim Stynes who show a brave and positive face to the public when confronted…

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Being blindly and unrelentingly positive can be a burden to disease sufferers. Image from shutterstock.com

Of all the cultural beliefs about health and illness that saturate the developed world, there is none so pervasive and deeply held as the idea that you can “battle” an illness by sheer force of will.

We admire people like AFL great Jim Stynes who show a brave and positive face to the public when confronted with a diagnosis of cancer, and somehow expect that a positive and determined mindset will help “overcome” the disease.

The underlying assumption here is that the mind and body are separate, a philosophical stance known as dualism.

In contrast, the scientific viewpoint is that the mind is caused by the brain. And all the neuroscientific data points this way.

So what, you may say. Even if the mind is caused by the brain, I can still consciously control my thoughts, and therefore I can influence things that go on in my body. This is quite true.

The next question, then, is whether there is evidence that optimism, positive thinking or learning to control your thoughts in some way will be enough to have a significant influence on any disease process.

It’s important to note that we’re not talking about quality of life. We’re interested in whether the actual course of a disease can be changed by purely mental effort.

People who are optimistic are more likely to turn up to health appointments. Image from shutterstock.com

It’s commonsense (and supported by mountains of positive studies) that sick people’s quality of life can be improved by having a positive outlook.

The consensus is that optimistic people turn up for their treatments more regularly and are more likely to find resourceful ways to get as much as they can out of their life with chronic illness.

Interestingly, pessimism may be more predictive of a bad outcome than optimism is of a good one.

What does the evidence say?

The most comprehensive summary of the evidence on the subject of optimism and health is this 2010 analysis of 83 studies . Most of the studies take a cohort of subjects, score them by questionnaire to rate their levels of optimism, then sit back and watch what happens.

There are no control groups and no intervention to assess – the researchers just trawl the data for a correlation. If links are found, which isn’t always the case, a press release is issued and everyone marvels at how amazing the mind-body connection is.

Even if you find a robust and reproducible correlation, it doesn’t automatically follow that the link is causal. This is especially true if the study was not specifically set up to show the exact link you are looking for, with all bias and potential distractions removed.

I couldn’t find any studies that were set up to look at the effect of becoming more optimistic, or switching from pessimism to optimism, on a person’s disease.

But at least there’s no harm in being positive, right?

There’s not, but it’s possible that being blindly and unrelentingly positive can be a burden to disease sufferers.

US researcher James Coyne make this point in his 2010 paper critiquing the positive psychology movement in cancer care. Coyne notes that enforcing a cultural expectation of positivity leaves many cancer patients scared that they’re reducing their chance of survival every time they feel scared, depressed or angry about their disease.

The paper quotes Dutch Olympian Maarten Van der Weijden, who rejected being identified with Lance Armstrong’s approach of “fighting” cancer:

What he basically says is that it is your own fault when you don’t make it… You always hear those stories that you have to think positively, that you have to fight to survive. This can be a great burden for patients.

Don’t feel you need to be completely positive 100% of the time. Image from shutterstock.com

Cancer patients should be reassured that their disease was not caused by personality or emotional factors. Such a callous and false conclusion follows logically from a serious acceptance of the myth. It also would follow that cancer, multiple sclerosis, stroke or any other serious disease could be curable by addressing the emotional issues that supposedly underlie it.

So if there’s little evidence that just being an optimistic person is good for your health, there’s even less evidence that forcing yourself to use positive thinking can beat your disease. Positive psychology interventions have only really been studied in mental health diseases such as depression and there seems to be no attempt to use thought to cure disease.

If faced with a serious illness, you’re likely to have a better quality of life if you have good social supports and avoid giving in to complete pessimism. Nobody can tell you the perfect formula to deal with the impact of a serious diagnosis.

But don’t believe those who tell you your illness is your fault somehow, or that you wouldn’t have it if you’d somehow been a better person.

You don’t need to feel that you should be completely positive 100% of the time, because not only does that not happen, it’s not healthy either. Coping the best way you know how to is all you should be aiming to do.

The effect of menopause on the skin and other connective tissues.

One of the many unpleasant results of menopause is the effect it has on the skin – viz aging. This can be avoided,however, by replacing the oestrogen missing in the body. This study below adds to our knowledge about the effect of menopause on the skin.
Gynecol Endocrinol. 2012 Apr;28(4):273-7. doi: 10.3109/09513590.2011.613970. Epub 2011 Oct 4.

The effect of menopause on the skin and other connective tissues.

Source

Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Malta. jean.calleja-agius@um.edu.mt

Abstract

Cutaneous ageing manifests itself as a progressive reduction in function and reserve capacity of skin tissue. Collagen atrophy is a major factor in skin ageing. There is a strong correlation between skin collagen loss and oestrogen deficiency due to the menopause. Skin ageing is associated with a progressive increase in extensibility and a reduction in elasticity. With increasing age, the skin also becomes more fragile and susceptible to trauma, leading to more lacerations and bruising. Furthermore, wound healing is impaired in older women. Oestrogen use after the menopause increases collagen content, dermal thickness and elasticity, and it decreases the likelihood of senile dry skin. Large-scale clinical trials are necessary to help make informed recommendations regarding postmenopausal oestrogen use and its role in the prevention of skin ageing. Oestrogen has profound effects on connective tissue turnover, no matter the site. It has been shown that menopause has similar effects on the connective tissue of the carotid artery media, intervertebral discs and bones.

Good use for Emu Oil.

Emu oil may help in common bowel diseases

Monday, 15 April 2013

New research is showing that emu oil has therapeutic potential for the treatment of a variety of common bowel diseases in addition to the intestinal damage caused by cancer chemotherapy.

Used by Australian indigenous populations as a skin wound treatment, and anecdotally regarded as useful in reducing bowel inflammation, research at the University of Adelaide has not only supported emu oil’s anti-inflammatory properties, but shown that it can also help to repair damage to the bowel.

Laboratory experiments by Physiology PhD candidate Suzanne Mashtoub Abimosleh have shown that emu oil accelerates the repair process, following disease-causing injury, by stimulating growth of the intestinal ‘crypts’. The crypts are the part of the intestine that produces the villi which absorb the food.

“Longer crypts and villi mean a healthier bowel that can better absorb food,” says Research Leader Professor Gordon Howarth, Cancer Council Senior Research Fellow with the University’s School of Animal and Veterinary Sciences.

Ms Abimosleh says: “Disorders of the gastrointestinal tract, such as the inflammatory bowel diseases and chemotherapy-induced mucositis, are associated with malabsorption of food together with inflammation and ulceration of the bowel lining (mucosa).

“The variable responsiveness of treatments to these diseases shows the need to broaden approaches, to reduce inflammation, prevent damage and promote healing.”

A series of laboratory studies showed emu oil treatment:

  • produced greater elongation of intestinal crypts (indicating enhanced recovery and repair) and reduced the severity of damage in intestines affected with ulcerative colitis;
  • significantly decreased acute intestinal inflammatory activity in non-steroidal anti-inflammatory drug (NSAID)-induced gastrointestinal disease;
  • decreased acute inflammation and improved repair of the chemotherapy-damaged intestine.

“The symptoms of mucositis – which include painful ulcers throughout the gastrointestinal tract – are experienced by 40-60% of all cancer patients undergoing chemotherapy worldwide and currently there are no effective treatment options,” says Ms Abimosleh.

Professor Howarth says the next steps include clinical trials, possibly initially with patients suffering from conditions such as irritable bowel syndrome.

“We’ve now done sufficient studies in the laboratory to show that emu oil has potential to help reduce the debilitating symptoms of these conditions and to enhance intestinal recovery,” Professor Howarth says. “We are now looking at further work to look at emu oil dosages, and whether the beneficial effects can be reproduced in clinical trials.”

Prostate Cancer Screening

Looser Guidelines Issued on Prostate Screening

By
Published: May 3, 2013

In a major shift, the American Urological Association has pulled back its strong support of prostate cancer screening, saying that the testing should be considered primarily by men aged 55 to 69.

The association had staunchly defended the benefits of screening men with the prostate test, even after a government advisory committee, the United States Preventive Services Task Force, said in 2011 that healthy men should not be screened because far more men would be harmed by unnecessary prostate cancer treatments than would be saved from death.

But in new guidelines issued Friday, the urology association says that routine screening is no longer recommended for men 40 to 54 years old who are at average risk of getting prostate cancer. Screening is also not recommended for men 70 and older.

The guidelines say men 55 to 69 should discuss the benefits and harms of screening with their doctors. And if they do choose screening, an interval of two years rather than annually would be better.

“It’s time to reflect on how we screen men for prostate cancer and take a more selective approach in order to maximize benefit and minimize harms,” Dr. H. Ballentine Carter, a professor of urology and oncology at Johns Hopkins University and chairman of the committee that drafted the guidelines, said in a statement.

The urology association’s previous recommendation, issued in 2009, was that blood testing for P.S.A., which stands for prostate-specific antigen, should be offered to men starting at age 40. Millions of men now get the P.S.A. test, many as part of their annual checkup.

When the government advisory task force recommended against screening, urologists, who treat many men with prostate cancer, expressed outrage, with one saying the policy was “flawed, dangerous and catastrophic for men.”

But some prostate cancer experts say the association risked losing credibility had it stuck to its recommendations for widespread screening. The new guidelines, they say, could preserve P.S.A. screening by recommending more moderate use.

The association “is not dismissing the P.S.A. test as the task force has done,” said Dr. Philip W. Kantoff, a prostate cancer specialist at the Dana-Farber Cancer Institute in Boston who was a member of the guidelines committee. “There should be a more reasonable approach to the use of P.S.A.”

Dr. David F. Penson, chairman of the urology association’s health policy council, said the new guidelines reflected the results of two recent clinical trials. “We just put our recommendations in line with the evidence,” he said.

The problem with screening is that levels of P.S.A. can be elevated for reasons having nothing to do with prostate cancer. That leads many men to have unnecessary biopsies, which can cause pain and infections. And biopsies find many cancers that would be so slow-growing that they would never harm the man. Because it is difficult to distinguish the dangerous from the nonaggressive tumors, however, most men undergo surgery or radiation treatments and then suffer from side effects like incontinence and erectile dysfunction.

In its guidelines on Friday, the association said that for men 55 to 69, screening would prevent one prostate cancer death for every 1,000 men screened over a decade.

The guidelines say that some men at higher-than-average risk of getting prostate cancer, such as those with a family history or who are African-Americans, could discuss the benefits and harms of starting screening at an age earlier than 55.

Some experts skeptical of screening have noted that the advent of P.S.A. testing led to a big jump in the number of diagnoses of prostate cancer, increasing the business of urologists. The P.S.A. test underpins a prostate cancer industry, consisting of laboratories that do biopsies, manufacturers of surgical robots and radiation equipment, even suppliers of adult diapers.

Dr. Otis W. Brawley, the chief medical officer of the American Cancer Society, has been a critic of mass screening campaigns, such as those held at shopping malls. “There has been a lot of money made by hospitals and clinics doing these mass screenings,” he said, referring to the treatment after cancer is found.

Dr. Brawley said the new urological association guidelines were “wonderful” if they were put into effect and would bring the association closer to the position of the American Cancer Society.

Not “In The Mood”? Consider This Herb

Wednesday 07/17/2013 Join the conversation!

Not “In The Mood”? Consider This Herb
Looking for a natural way to boost your sex drive? An herbal possibility is the Mexican plant damiana (Turnera diffusa). Although it has not been extensively studied, it has a widespread reputation as a female aphrodisiac. You can readily find damiana preparations in health food stores. Follow dosage recommendations on the label. If you don’t notice any improvement after taking it for a month or two, discontinue use.

Another way to boost your sex drive is through cultivating physical and mental well-being – both are important to a healthy libido. Think about the interplay of emotional charge, mental imagery and body responses associated with intimacy. Hypnotherapy and guided imagery can help you make the most of the mind-body connection in overcoming sexual problems. Many experts say that the greatest aphrodisiac is the human mind

We can all learn from each other.

I received this email from one of my long-term patients (although I don’t like that word much, as it does not really apply to the people I help, but don’t know of a better word). I recently blogged an article on the wonderful benefits of oestrogen (Aug 14 – see under archives), yet more lovely actions of oestrogen keep coming. I encourage others of you with similar stories to share them. At a recent conference on hormones, a wonderful american Doctor, Dr Pamela Smith, spoke about women’s brains being bathed in oestrogen most of their lives, and it is what makes women, women. Unlike men, whose brains are baked in testosterone all their lives, and we know what that does to them.

Dear Dr Holloway,
>
> Am undergoing tests for fungal pneumonia previously thought to be viral.
>
> Researching the disease online I discovered that oestrogen offers possible protection from some fungal infections like the lung problem I have and other systemic mycoses.(see attachments)
>
> My resistance to these infections was lowered when I lost troches at the beginning of 6 mos. overseas trip. (Aug 2011 to Feb.2012). During that time I had to substitute with natural supplements in Chile and Brazil (red clover isoflavones) but doubt it did much good and as you can see from my path test on return to Brisbane (March 2012) there was a significant depletion of hormones.(<43 E2 and <1 Prog.)!
>
> Then my negligence in maintaining my HRT in the year following has resulted in exactly the same result in last week’s tests! (<43 E2 and <1 Prog ). So, for more than a year my hormones have been minimal or zero.
>
> In that year of minimal or zero HRT protection, I have experienced two episodes of serious pneumonia/fungal lung infection. (Dec 2012 and Aug 2013) possibly triggered by air travel and/or unclean air conditioners in Singapore hotel accommodation or possibly a paracoccidioido infection, endemic in parts of S.America.
>
> Hopefully resuming the HRT will reinstate the protection I have had in my previous 25 years of use. How long will it take for the hormones to resume their correct levels?
>
> Perhaps this correlation of oestrogen and protection from fungal lung disease will be of interest to you?
>
> Kind regards,
> Dianne

What do you know – Another major study proves natural hormones better than synthetic.

Do not worry about the confusing genetic and biochemical terminology. This is all medical/expert speak. The important bit is in the conclusion, which I have highlighted. And yet, there are still some doctors who defend the synthetic HRT as being safer than the natural HRT, in spite of the overwhelming evidence.
Gynecol Endocrinol. 2012 Oct;28 Suppl 2:12-5. Epub 2012 Jul 27.

Percutaneous estradiol/oral micronized progesterone has less-adverse effects and different gene regulations than oral conjugated equine estrogens/medroxyprogesterone acetate in the breasts of healthy women in vivo.

Source

Department of Obsterics and Gynecology, Södertälje Hospital, Södertälje, Sweden.

Abstract

Gene expression analysis of healthy postmenopausal women in a prospective clinical study indicated that genes encoding for epithelial proliferation markers Ki-67 and progesterone receptor B mRNA are differentially expressed in women using hormone therapy (HT) with natural versus synthetic estrogens. Two 28-day cycles of daily estradiol (E2) gel 1.5 mg and oral micronized progesterone (P) 200 mg/day for the last 14 days of each cycle did not significantly increase breast epithelial proliferation (Ki-67 MIB-1 positive cells) at the cell level nor at the mRNA level (MKI-67 gene). A borderline significant beneficial reduction in anti-apoptotic protein bcl-2, favouring apoptosis, was also seen followed by a slight numeric decrease of its mRNA. By contrast, two 28-day cycles of daily oral conjugated equine estrogens (CEE) 0.625 mg and oral medroxyprogesterone acetate (MPA) 5 mg for the last 14 days of each cycle significantly increased proliferation at both the cell level and at the mRNA level, and significantly enhanced mammographic breast density, an important risk factor for breast cancer. In addition, CEE/MPA affected around 2,500 genes compared with just 600 affected by E2/P. These results suggest that HT with natural estrogens affects a much smaller number of genes and has less-adverse effects on the normal breast in vivo than conventional, synthetic therapy.

20 things I wish I knew when I was 30.

Kareem: 20 Things I Wish I’d Known When I Was 30

at 7:00AM

When I was thirty, I was living my dream. I’d already accomplished  most of what I’d set out to achieve professionally: leading scorer in the NBA,  leading rebounder, leading blocker, Most Valuable Player, All-Star. But success  can be as blinding as Bill Walton’s finger in the eye when battling for a  rebound. I made mistakes. Plenty of them. In fact, sometimes I wish I could  climb into a time machine and go back to shake some sense into that  thirty-year-old me. If I could, here’s the advice I would give him:

1. Be more outgoing. My shyness and introversion from those days still  haunt me. Fans felt offended, reporters insulted. That was never my intention.  When you’re on the public stage every day of your life, people think that you  crave attention. For me, it was the opposite. I loved to play basketball, and  was tremendously gratified that so many fans appreciated my game. But when I was  off the court, I felt uncomfortable with attention. I rarely partied or attended  celebrity bashes. On the flights to games, I read history books. Basically, I  was a secret nerd who just happened to also be good at basketball. Interacting  with a lot of people was like taking someone deathly afraid of heights and  dangling him over the balcony at the top of the Empire State Building. If I  could, I’d tell that nerdy Kareem to suck it up, put down that book you’re using  as a shield, and, in the immortal words of Capt. Jean-Luc Picard (to prove my  nerd cred), “Engage!”

2. Ask about family history. I wish I’d sat my parents down and asked  them a lot more questions about our family history. I always thought there would  be time and I kept putting it off because, at thirty, I was too involved in my  own life to care that much about the past. I was so focused on making my parents  proud of me that I didn’t ask them some of the basic questions, like how they  met, what their first date was like, and so forth. I wish that I had.

3. Become financially literate. “Dude, where’s my money?” is the  rallying cry of many ex-athletes who wonder what happened to all the big bucks  they earned. Some suffer from unwise investments or crazy spending, and others  from not paying close attention. I was part of the didn’t-pay-attention group. I  chose my financial manager, who I later discovered had no financial training,  because a number of other athletes I knew were using him. That’s typical athlete  mentality in that we’re used to trusting each other as a team, so we extend that  trust to those associated with teammates. Consequently, I neglected to  investigate his background or what qualified him to be a financial manager. He  placed us in some real estate investments that went belly up and I came close to  losing some serious coin. Hey, Kareem at 30: learn about finances and stay on  top of where your money is at all times. As the saying goes, “Trust, but  verify.”

4. Play the piano. I took lessons as a kid but, like a lot of kids,  didn’t stick with them. Maybe I felt too much pressure. After all, my father had  gone to the Julliard School of Music and regularly jammed with some great jazz  musicians. Looking back, I think playing piano would have given me a closer  connection with my dad as well as given me another artistic outlet to better  express myself. In 2002, I finally started to play and got pretty good at it.  Not good enough that at parties people would chant for me to play “Piano Man,” but good enough that I could read music and feel closer to my dad.

5. Learn French. My grandparents were from Trinidad where, though it  was an English-speaking country, the school system was started by the French.  Whenever my grandparents wanted to say something they didn’t want me to know,  they’d speak French. The language seemed so sophisticated and mysterious. Plus,  you earn extra James Bond points when you can order in French in a French  restaurant.

6. Get handy. I always wanted to be one of those guys who, whenever  something doesn’t work, straps on a tool belt and says, “I’ll fix it.” I like  the Walden-esque idea of complete self-reliance. Build my own house, clean out  the carburetors, find out what carburetors are. Recently my washing machine  broke and flooded my entire downstairs. I was forced to stand idly by waiting  for a plumber to arrive while water rose around my ankles because I didn’t know  how to shut off the water. That’s the kind of experience that makes you have  your testosterone levels checked.

7. Be patient. Impatience is the official language of youth. When  you’re young, you want to rush to the next thing before you even know where you  are. I always think of the joke in Colors that the wiser and older cop  (Robert Duvall) tells his impatient rookie partner (Sean Penn). I’m  paraphrasing, but it goes something like: “There’s two bulls standing on top of  a mountain. The younger one says to the older one: ‘Hey pop, let’s say we run  down there and screw one of them cows.’ The older one says: ‘No son. Let’s walk down and screw ’em all.’” Now, to counter the profane with the  profound, one of my favorite quotes is from the philosopher Arthur Schopenhauer: “Talent hits the target no one else can hit; genius hits the target no one else  can see.” I think the key to seeing the target no one else can see is in being  patient, waiting for it to appear so you can do the right thing, not just the  expedient thing. Learning to wait is one of my greatest accomplishments as I’ve  gotten older.

8. Listen more than talk. And that’s all I’m going to say about that.

9. Career is never as important as family. The better you are at your  job, the more you’re rewarded, financially and spiritually, by doing it. You  know how to solve problems for which you receive praise and money. Home life is  more chaotic. Solving problems is less prescriptive and no one’s applauding or  throwing money if you do it right. That’s why so many young professionals spend  more time at work with the excuse, “I’m sacrificing for my family.” Bullshit.  Learn to embrace the chaos of family life and enjoy the small victories. This  hit me one night after we’d won an especially emotional game against the  Celtics. I’d left the stadium listening to thousands of strangers chanting “Kareem! Kareem!” I felt flush with the sense of accomplishment, for me, for the  Lakers, and for the fans. But when I stepped into my home and my son said, “Daddy!” the victory, the chanting, the league standings, all faded into a  distant memory.

10. Being right is not always the right thing to be. Kareem, my man,  learn to step away. You think being honest immunizes you from the consequences  of what you say. Remember Paul Simon’s lyrics, “There’s no tenderness beneath  your honesty.” So maybe it’s not that important to win an argument, even if you “know” you’re right. Sometimes it’s more important to try a little  tenderness.

11. Cook more. After I got divorced I missed home cooked meals and the  only person I had to rely on was the guy in the mirror. Plus, I found it  impressed women if you could cook a good meal. Once, very shortly after I  started cooking for myself, I had a first date with a woman I really wanted to  make a good impression on. Of course, I could have done the usual celebrity  thing: fancy restaurant, signing autographs, wait-staff fawning. But I wanted  this to be special, so I decided to cook for her, everything from soup to  dessert. Some women get a little freaked seeing a 7’2” black man with a carving  knife and butcher’s apron, but she appreciated the effort. Which was good  because the soup was a little salty, the steak a little overcooked, and the flan  a little watery…

12. When choosing someone to date, compassion is better than passion.  I’m not saying she shouldn’t be passionate. That’s a given. But look for signs  that she shows genuine compassion toward others. That will keep you interested  in her a lot longer.

13. Do one thing every day that helps someone else. This isn’t about  charity, this is about helping one individual you know by name. Maybe it means  calling your parents, helping a buddy move, or lending a favorite jazz album to  Chocolate Fingers McGee.

14. Do more for the community. This is about charity, extended  to people close by whose names you don’t know. You can always do  more.

15. Do one thing every day that you look forward to doing. It’s easy  to get caught up in the enormous responsibilities of daily life. The To Do List  can swallow your day. So, I’d insist to my younger self to make sure he has one  thing on that list that he looks forward to doing.

16. Don’t be so quick to judge. It’s human nature to instantly judge  others. It goes back to our ancient life-or-death need to decide whether to  fight or flee. But in their haste to size others up, people are often  wrong—especially a thirty-year-old sports star with hordes of folks coming at  him every day. We miss out on knowing some exceptional people by doing that, as  I’m sure I did. I think the biggest irony of this advice is that it’s coming  from someone who’s black, stratospherically tall, and an athlete: the trifecta  of being pre-judged. And I have a lifetime of hurtful comments to prove it. Yet,  that didn’t stop me from doing the same thing to others. You have to weigh the  glee of satisfaction you get from arrogantly rejecting people with the  inevitable sadness of regret you’ll eventually feel for having been such a dick.  A friend of mine told me he routinely attends all of his high school reunions so  he can apologize to every person he mistreated back then. He’s now on his  fortieth reunion and still apologizing.

17. When breaking up with a woman, you can’t always remain friends. I  have managed to stay friends with many of the women I have dated because I truly  liked and respected them. But sometimes emotions run too deep and efforts to  remain friends, while that might help you feel better, actually might make the  other person feel worse. Take the hit and let it go.

18. Watch more TV. Yeah, you heard right, Little Kareem. It’s great  that you always have your nose in history books. That’s made you more  knowledgeable about your past and it has put the present in context. But pop  culture is history in the making and watching some of the popular shows of each  era reveals a lot about the average person, while history books often dwell on  the powerful people.

19. Do more yoga. Yes, K, I know you do yoga already. That’s why  you’ve been able to play so long without major injuries. But doing more isn’t  just for the physical benefits, it’s for the mental benefits that will come in  handy in the years ahead, when your house burns down, your jazz collection  perishes, and you lose to the Pistons in a four-game sweep in your final  season.

20. Everything doesn’t have to be fixed. Relax, K-Man. Some stuff can  be fixed, some stuff can’t be. Deciding which is which is part of  maturing.

Read more: Life Lessons with Kareem Abdul-Jabbar – Kareem on What He Wished He’d Known – Esquire Follow us: @Esquiremag on Twitter | Esquire on Facebook Visit us at  Esquire.com

Facts about Vitamin D

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HEALTHbeat Harvard Medical School
January 10, 2013
HomeHealth NewslettersSpecial Health ReportsHealth BooksBrowse By TopicBlog

6 things you should know about vitamin D

Figuring out all the factors that can affect your vitamin D level is complicated. Your body makes vitamin D when sunlight hits the skin. You can also get the vitamin from food (mainly because it’s been added; few foods are natural sources of vitamin D) or by taking a supplement.

The process by which the body makes vitamin D is complex. It starts when the skin absorbs rays in the invisible ultraviolet B (UVB) part of the light spectrum. The liver and the kidneys also participate to make a form of the vitamin that the body can use.

A number of factors influence a person’s vitamin D levels. Here are six important ones.

1. Where you live. The further away from the Equator you live, the less vitamin D–producing UVB light reaches the earth’s surface during the winter. Residents of Boston, for example, make little if any of the vitamin from November through February. Short days and clothing that covers legs and arms also limit UVB exposure.
2. Air quality. Carbon particles in the air from the burning of fossil fuels, wood, and other materials scatter and absorb UVB rays, diminishing vitamin D production. In contrast, ozone absorbs UVB radiation, so pollution-caused holes in the ozone layer could end up enhancing vitamin D levels.
3. Use of sunscreen. Sunscreen prevents sunburn by blocking UVB light. Theoretically, that means sunscreen use lowers vitamin D levels. But as a practical matter, very few people put on enough sunscreen to block all UVB light, or they use sunscreen irregularly, so sunscreen’s effects on vitamin D might not be that important. An Australian study that’s often cited showed no difference in vitamin D between adults randomly assigned to use sunscreen one summer and those assigned a placebo cream.
4. Skin color. Melanin is the substance in skin that makes it dark. It “competes” for UVB with the substance in the skin that kick-starts the body’s vitamin D production. As a result, dark-skinned people tend to require more UVB exposure than light-skinned people to generate the same amount of vitamin D.
5. Weight. Body fat sops up vitamin D, so it’s been proposed that it might provide a vitamin D rainy-day fund: a source of the vitamin when intake is low or production is reduced. But studies have also shown that being obese is correlated with low vitamin D levels and that being overweight may affect the bioavailability of vitamin D.
6. Age. Compared with younger people, older people have lower levels of the substance in the skin that UVB light converts into the vitamin D precursor. There’s also experimental evidence that older people are less efficient vitamin D producers than younger people.

For more information on the benefits of vitamin D as well as advice on making sure you get the proper amount of vitamins and minerals in your diet, buy Vitamins and Minerals, a Special Health Report from Harvard Medical School.

When It Comes to Our Brains, Study Suggests Yoga Trumps Running

When It Comes to Our Brains, Study Suggests Yoga Trumps Running

We’ve learned that yoga can make us limber like Gumby, help relieve anxiety and pain, and reduce blood pressure [1] [2]. And all those warrior and dog poses can help get us into serious shape. But what about our brains?

A new study not only suggests that yoga is good for our brains, but that it actually makes them work better. Find out how yoga, and exercise, contribute to a healthier brain below.

What’s the Deal?
University of Illinois grad student Neha Gothe and her colleagues used 30 female college students as subjects in the study. The students visited the lab on three separate days (without having exercised at all). On the first visit — the baseline session — students completed an exercise history questionnaire, and then the researchers led them through two cognitive tests: The Flanker Task, and the N-back Task. (Basically, the first test measures working memory, while the second measures attention span.)

On the second day, participants practiced 20 minutes of Hatha yoga (a style known for its emphasis on breathing). Each woman wore a heart rate monitor while getting her yoga on and the researchers measured resting heart rate pre-yoga, and their heart rate after the 20 minutes (though it’s unclear how this data was analyzed in the results). The practice included seated and standing postures, contraction and relaxation of different muscles, and concluded with a short meditation with deep breathing. (Note: The researchers excluded participants who were regular practitioners of yoga or other mind-body based exercises such as tai-chi and martial arts.)

The third day focused on aerobic exercise as the women hopped on a treadmill and walked or jogged for 20 minutes. For consistency’s sake, each subject exercised at a speed and incline to maintain 60 to 70 percent of her maximum heart rate for the full session (a range shown to improve cognitive performance) [3].

After each exercise session, the participants took the cognitive tests again. The researchers found that test scores were significantly better following the stint of yoga — reaction times were shorter and accuracy was greater after the yoga session compared to 20 minutes on a treadmill. Perhaps even more interesting, jogging resulted in nearly the same cognitive performance as the baseline testing when the women didn’t exercise at all.

Is it Legit?

According to previous research, “Yes.” This isn’t the first time researchers have linked exercise and cognitive performance, though most previous studies focus on aerobic activity [4] [5]. And in terms of time spent getting buff, both continuous training and occasional bursts of activity have been shown to positively affect cognition [6] [7].

The study sample was admittedly super small and only included ladies (sorry, gentleman). But what’s cool about this study is that it’s one of the first to investigate the immediate effects of exercise on our brains (tested within five minutes of leaving the yoga mat or hopping off the treadmill).

One possible explanation for yoga’s superpowers on our brains is the “mind-body connection,” using thoughts to positively influence some of the body’s physical responses. The researchers explained that a combination of meditation, breathing, and body awareness may very well explain increased attention. We’d like to see the researchers study practicing yogis (rather than just newbs) in the future. And hey, if this research is one more reason to roll out the yoga mat, then we’re in!