July 2003

IN THIS MONTH'S ISSUE

• Estrogen and Dementia
• The Annual Strong Women Essay Contest
• Reader Questions and Answers
• Does fiber affect calcium absorption?
• How should I time strength training with other activities?
• Can my husband do the program, too?
• From the Mailbox — Success Stories
• Recipe — Teriyaki Chicken and Pineapple Skewers

ESTROGEN AND DEMENTIA

Just one year ago, I reported on the early termination of the Women's Health Initiative (WHI) because of an unacceptable number of adverse events (increase in heart disease and cancer) in the group of women who received hormone replacement therapy (HRT). One month ago, another very important report from the WHI was published in the Journal of the American Medical Association detailing the effects of HRT on dementia. Dementia is diagnosed when forgetfulness or cognitive impairments are severe enough to interfere with normal daily life or social interactions. The most common form of dementia is Alzheimer's Disease.

To review, HRT is the second most widely issued prescription in the United States, which means it has the potential to benefit or harm many women. Given the findings of both benefits and risks for HRT, the National Institutes of Health began a research study involving a large group of ethnically diverse women to assess the cumulative benefits and/or risks of taking HRT.

For the Women's Health Initiative Memory Study (WHIMS), 4,532 women aged 65 and older within the WHI main study were recruited starting in May 1996. Half of the women received PremPro (0.625 mg of conjugated equine estrogen and 2.5 mg of medroxyprogesterone acetate) and the other half received a placebo. At the beginning of the study all women were free of dementia. The study was stopped in May of 2002. This arm of the WHI finally clears up a very important question -- for years scientists have thought that HRT might help memory and decrease risk of Alzheimer's disease; this study demonstrated that this is not the case--in fact, the opposite may be true.

Over the course of the study 61 women were diagnosed with dementia. More women in the HRT group (61%) were diagnosed with probable dementia than women in the placebo group (34%). Nearly twice as many women in the HRT group were diagnosed with dementia!

While this study does answer an important question, it doesn't answer others, such as whether short-term use of HRT (less than 1 year) for the treatment of hot flashes and other menopausal symptoms has risks. For now, if you are taking HRT or estrogen or are considering them, I suggest that you talk with your doctor. For most women, the benefits of taking HRT do not outweigh the risks.

More power to you,
Miriam E. Nelson
Author of
Strong Women Stay Young
Strong Women Stay Slim
Strong Women, Strong Bones
Strong Women Eat Well
Strong Women and Men Beat Arthritis
Founder of http://www.strongwomen.com

(Reference: Shumaker and colleagues. Estrogen Plus Progestin and the Incidence of Dementia and Mild Cognitive Impairment in Postmenopausal Women. Journal of the American Medical Association 2003;289:2651-2662.)

STRONGWOMEN SUMMIT
LIMITED SPACE AVAILABLE!

As announced in earlier newsletters, I have teamed up with Stonyfield Farm to host the Strong Women Summit this coming November featuring, Erin Brockovich, myself and other inspiring, strong women. The Stonyfield Farm Strong Women Summit will celebrate, educate and motivate women to believe that positive thinking and activism begin with health, good nutrition, exercise and attitude. Net proceeds from the Strong Women Summit will benefit the Friedman School of Nutrition Science and Policy at Tufts University, where I work. The mission of the Friedman School is to improve the nutritional well-being of people worldwide through the creation of new knowledge, the application and dissemination of evidence-based information and the education and training of future leaders in the field.

To find out more about the Stonyfield Farm Strong Women Summit or to register go to: www.stonyfield.com/strongwomen. Or call: 1-800-PRO-COWS for more information.

Q: Q: I have a problem with constipation and try to eat lots of fiber (bran cereals) and take Metamucil. I just read that this fiber prevents the absorption of calcium. What should I do to make sure I'm getting enough calcium? I've just been diagnosed with osteopenia.

A: Both constipation and osteopenia are conditions that you need to address. First, you should talk with your doctor about both conditions and make sure that you are doing everything possible to help. I recommend that you get plenty of exercise. In addition, make sure that you are eating a well-rounded diet that is full of fruits and vegetables and whole grains, along with 3 to 4 low-fat dairy foods (low-fat milk and yogurt) and a minimum of processed foods. Drink plenty of water and other non-caloric beverages. Exercise and good nutrition will help with both conditions. Take your fiber supplement in the morning with breakfast and take your calcium and vitamin D supplement in the evening. Taking your calcium and vitamin D supplement at a time of day when your gut is dealing with less fiber will help with absorption. Also, taking a calcium citrate supplement (i.e., Citracal) will help with calcium absorption.

Q: I know that strength workouts have to be spaced with a day of rest in between, but can I do other activities such as rock climbing on the off-days or will that hinder my strength gains?

A: Both the strengthening exercises outlined in my books as well as rock climbing require a great deal of strength to complete. But the two types of routines are different enough, requiring the use of different muscle groups, that you can do them on alternating days. Ideally, you would strength train 2 to 3 times per week with a couple of days of rock climbing on days when you are not strength training. Because both activities are intense, you need to listen to your body, and if it seems as though you are not recovering quickly enough after a workout, take the day off and just do light or moderate activity. Adding variety to your regular exercise routine is very important and will help you reach new heights with your overall fitness.

Q: I would like to know what a husband should do if he, too, wants to do weight lifting. I have watched your video and continue with that now and like it very much. Is there anything for men?

A: Although men start off with more muscle, bone, and strength than women in general, strengthening exercises are important for them as well, especially as they grow older. The strength training programs in both the video and books are safe and effective for men, too. The only difference is that they may want to start with heavier weights. For instance, while a woman may start the biceps curl with 3- or 5-lb dumbbells, a man may start with 5- or 8-lb dumbbells. But in general, both the exercises and the recommendations for sets and reps are perfectly appropriate for your husband.

I would like to offer my heartfelt thanks to you for writing such wonderful books. I bought your Strong Women Stay Young book in 1998 and my mom and I started the weight training program in March of that year. My mom is 68 and I will turn 40 in August. In addition to the weight training, we walk everyday. We have never felt better. It is very empowering to be strong and healthy.

-- Charlene

Five years ago I was very ill with the mysterious illness Chronic Fatigue Syndrome. Through the years I have slowly improved, but my muscles were very weak. I was very happy to find your book that offered me a way to exercise at home. When I first began, I could not even lift one pound, so I worked without weights. Now, after a year, I am lifting 9 lbs. on the legs, 4 lbs. on the overhead triceps, and 10 lbs. on the rest of the arm exercises! I am so thrilled and proud to be doing this! There are bad days when I simply can't lift 8 repetitions in a row. Then I will go as far as I can (6 or 7). Sometimes I have to rest 5 minutes in-between sets. Other days I go trucking along fine. I'm advancing, and am certainly feeling better physically and mentally because of it. I'm confident I will continue this program till the day I die--I, who had never done any exercise program before.

-- Gaye

Cut uncooked breasts into pieces (large bite-sized) and place in zip-lock bag or storage container. Add teriyaki sauce and marinate at least 1 hour (preferably in the refrigerator over night).

Remove chicken from marinade and set aside for basting while grilling. Skewer approximately two pieces of chicken for every one chunk of pineapple. If using wooden skewers, make sure to moisten them before skewering to minimize burning while grilling.

Grill, rotating every few minutes, for about 15 minutes, or until chicken is cooked through; do not overcook.

This dish is excellent served with brown rice and freshly grilled green veggies such as snow peas or broccoli.