Your Thoughts Impact How You Age


Scott Bea, PsyD, of Cleveland Clinic, says for years doctors have had notions that attitudes and thoughts may predispose us to early aging.


More and more these notions are turning into scientific research.


He says there are different types of negative thinking.  Each can be impactful.


“One is just cynical hostility, where you know, we stew a lot,” says Dr. Bea. “When people are kind of suspicious and pretty certain the world or folks are against them it stays with them; and keeps stress chemicals like cortisol circulating in the body too long.”

Dr. Bea says some studies have looked at how certain types of behavior and thought patterns can impact our aging and DNA.


He says we tend to lump all negative thinking into one place, but there are actually many little ways that can actually harm us by influencing our telomeres, which are – the tips at the end of our DNA that affect the aging process.


Thoughts like pessimism – — always predicting doom and gloom, as well as ruminating, which is dredging up past events and mulling them over and over again, can keep stress chemicals active and alive.


Dr. Bea also says thought suppression – where we actively try to avoid thoughts – takes a lot of activity and tension and tends to overload our brains.


What to do?  When we’ engage in the outside world, and not in our own heads, Dr. Bea says we can better handle these negative thought patterns.


The key is to be able to recognize that thoughts are just thoughts.

“Dr. Bea recommends you do the following to cut off negative self-talk:

Say to yourself, ‘I’’m allowed to think without trying to fix or solve anything.’ “

Use simple mindfulness exercises that can be done, even in five second bursts at various times throughout the day.  Focus on the sensation of your breath.

If something distracts you (sights, sounds) ease your attention back to your breath.


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MY two cents and what I recommend. My blog. My two cents: 
I subscribe to something called DAILY PRIME.  You know how a “Good Morning Beautiful” text from your significant other can make you wake up with a smile.
Well, relationships ebb and flow, so you can’t count on consistency. It can also border on creepy if it’s not from your SO.  DAILY PRIME is consistently in a positive, good mood.
Here’s how it works. Each morning, I get an amazing, positive, motivational, inspirational text that kick starts the rest of my day. You pick a time preference.
It’s created by John Assaraf.

John and his wife Maria are two of my favorite people in the world. When I first met them we walked in San Diego for Rady’s Children Hospital.

They’ve wonderful energy and such an authentically calm, healing presence. It’s the kind of good, positive energy that radiates from within. I

When you get to that state, it benefits your well-being and everyone in your presence.

Assaraf has been preaching thoughts equals things way before before The Secret (which he appeared in) was on Oprah or studies confirm it.
One of my favorite books, The Power of Positive Thinking did too.
Positive THOUGHTS lead you to make positive ACTIONS.
Also, you can do things that release the opposite of cortisol in your body. There are naturally healthy healing chemicals and hormones inside your body, but it takes action to release them.
Actions like daily exercise, listening to music, mediating, spending time in nature or with positive family and friends, laughing, petting your dog, and hugging release endorphins.
Love is a biggie. It releases all the feel good hormones, including oxytocin. I read a great book about it in 2014 and interviewed author, Paul J. Zak for this blog. It’s called The Moral Molecule: The Source of Love and Prosperity.  I
I was recently interviewed on a radio program about mind-body connection –hot topic.
Stay healthy!
I was delighted to meet Brian Tracy while in San Diego.  I attended one of his conferences and brought one of his books with me. Without my even asking he graciously says, “Let me sign that.” He wrote, “Maria, You can do it!” inside it.  That’s positivity for you. Whatever “it” is doesn’t matter when someone believes in you.

How To Be More Positive by Brian Tracy

Your mental diet largely determines your character and your personality and almost everything that happens to you in life.

What is a mental diet? Keep reading and I’ll explain…

When you feed your mind with positive affirmations, information, books, conversations, audio programs, and thoughts, you develop a more positive attitude and personality.

You become more influential and persuasive. You enjoy greater confidence and self-esteem.

Those who work with computers use the expression “G.I.G.O.” or “Garbage in, Garbage out.” But the reverse is also true, “Good in, Good out.”

When you make a clear, unequivocal decision that you are going to take complete control over your mind, eliminate the negative emotions and thoughts that may have held you back in the past, and become a completely positive person, you can actually bring about your own personal transformation.

Mental fitness is like physical fitness. You develop high levels of self-esteem and a positive attitude with training and practice. Here are the seven keys to becoming a completely positive person:

1) Positive Affirmations

Speak to yourself positively; control your inner dialog. Use positive affirmations phrased in the positive, present, and personal tense:

“I like myself!”

“I can do it!”

“I feel terrific!”

“I am responsible!”

We believe that fully 95% of your emotions are determined by the way you talk to yourself as you go throughout your day. The sad fact is that if you do not deliberately and consciously talk to yourself in a positive and constructive way, you will, by default, think about things that will make you unhappy or cause you worry and anxiety.

As we said before, your mind is like a garden. If you do not deliberately plant flowers and tend carefully, weeds will grow without any encouragement at all.

Discover your level of self-confidence and build greater confidence in yourself.

2) Positive Visualization

Perhaps the most powerful ability that you have is the ability to visualize and see your goals as already accomplished. Create a clear, exciting picture of your goal and your ideal life, and replay this picture in your mind over and over.

All improvement in your life begins with an improvement in your mental pictures. As you “see” yourself on the inside, you will “be” on the outside.

3) Positive People

Your choice of the people with whom you live, work, and associate will have more of an impact on your emotions and your success that any other factor. Decide today to associate with winners, with positive people, with people who are happy and optimistic and who are going somewhere with their lives.

Avoid negative people at all costs. Negative people are the primary source of most of life’s unhappiness. Resolve that from today onward, you are not going to have stressful or negative people in your life.

4) Positive Mental Food

Just as your body is healthy to the degree to which you eat healthy, nutritious foods, your mind is healthy to the degree to which you feed it with “mental protein” rather than “mental candy.” Read books, magazines, and articles that are educational, inspirational, or motivational.

Feed your mind with information and ideas that are uplifting and that make you feel happy and more confident about yourself and your world.

Listen to positive, constructive CDs and audio programs in your car and on your MP3 player or iPod. Feed your mind continually with positive messages that help you think and act better and make you more capable and competent in your field. Watch positive and educational DVDs, educational television programs, online courses, and other uplifting material that increases your knowledge and makes you feel good about yourself and your life.

5) Positive Training And Development

Almost everyone in our society starts off with limited resources, sometimes with no money at all. Virtually all fortunes begin with the sale of personal services of some kind. All the people who are at the top today were once at the bottom, and sometimes they fell to the bottom several times.

The miracle of lifelong learning and personal improvement is what takes you from rags to riches, from poverty to affluence, and from underachievement to success and financial independence.

As Jim Rohn said, ”Formal education will make you a living; self-education will make you a fortune.”

When you dedicate yourself to learning and growing and becoming better and more effective in your thoughts and actions, you take complete control of your life and dramatically increase the speed at which you move upward to greater heights.

6) Positive Health Habits

Take excellent care of your physical health and wellness. Resolve today that you are going to live to be eighty, ninety, or one hundred years old and still be dancing in the evenings. Eat healthy foods, natural and nutritious, and eat them sparingly and in proper balance. A nutritional diet will have an immediate, positive effect on your thoughts and feelings.

Resolve to get regular exercise, at least two hundred minutes of motion per week, walking, running, swimming, bicycling, or working out on equipment in the gym. When you exercise on a regular basis, you feel happier and healthier and experience lower levels of stress and fatigue than a person who sits on the couch and watches television all evening.

Especially, get ample rest and relaxation. You need to recharge your batteries on a regular basis, especially when you are going through periods of stress or difficulty.

Vince Lombardi once said, “Fatigue makes cowards of us all.”

Some of the factors that predispose us to negative emotions of all kinds are poor health habits, sleep deprivation, lack of exercise, and nonstop work. Seek balance in your life.

7) Positive Expectations

Practicing the Law of Attraction is one of the most powerful techniques you can use to become a positive person and to ensure positive outcomes and better results in your life. Your expectations become your own self-fulfilling prophesies.

Whatever you expect, with confidence, seems to come into your life. Since you can control your expectations, you should always expect the best.

Expect to be successful.

Expect to be popular when you meet new people. Expect to achieve great goals and create a wonderful life for yourself. When you constantly expect good things to happen, you will seldom be disappointed.


I hope you enjoyed this post on developing a more positive attitude with positive affirmations.  Please leave a comment and share with your friends!



Why You Need Positive People in Your Life

Happiness is a choice. But we continually need to be reminded by people to make that choice.

One big mistake people make is not realizing that happiness is an individual choice. But every choice is influenced by the people in our lives. If you change your life influencers for the better, you can dramatically increase your chances for happiness and success.

In my research, I’ve found that positive social connection is the greatest predictor of long-term happiness. Welcoming a positive new influencer into your world can be one of the most important choices for happiness you make. That person might be a professional life coach or a mentor or simply someone whom you respect and who has the positive outlook you want to emulate.

A positive influencer will have a few outstanding traits that rub off on you over time. This person will practice gratitude. He will seek joy daily and work at becoming his best self. He’ll enjoy being active and feel connected to others.

Think about the negative influences around you. These are people who focus on the bad things in their lives and cause you to do the same. You’ll be left searching for new problems to worry over. Negative influencers don’t smile or laugh easily. They have trouble maintaining relationships and see stress as a threat rather than a challenge to embrace. Steer clear!

We know that happiness is a choice. But we continually need to be reminded by people to make that choice, especially when life gets challenging. Think about the people you know who could be positive influencers and spend more time with someone who will improve your happiness and lead you to greater success.

The 10 Essential Habits of Positive People

Are you waiting for life events to turn out the way you want so that you can feel more positive about your life? Do you find yourself having pre-conditions to your sense of well-being, thinking that certain things must happen for you to be happier? Do you think there is no way that your life stresses can make you anything other than “stressed out” and that other people just don’t understand?  If your answer is “yes” to any of these questions, you might find yourself lingering in the land of negativity for too long!

The following are some tips to keep positive no matter what comes your way. This post will help you stop looking for what psychologists call “positivity” in all the wrong places!  Here are the ten essential habits of positive people.

1. Positive people don’t confuse quitting with letting go.

Instead of hanging on to ideas, beliefs, and even people that are no longer healthy for them, they trust their judgement to let go of negative forces in their lives.  Especially in terms of relationships, they subscribe to The Relationship Prayer which goes:

I will grant myself the ability to trust the healthy people in my life … 

To set limits with, or let go of, the negative ones … 

And to have the wisdom to know the DIFFERENCE!

 2.  Positive people don’t just have a good day – they make a good day.

Waiting, hoping and wishing seldom have a place in the vocabulary of positive individuals. Rather, they use strong words that are pro-active and not reactive. Passivity leads to a lack of involvement, while positive people get very involved in constructing their lives. They work to make changes to feel better in tough times rather than wish their feelings away.

3. For the positive person, the past stays in the past.

Good and bad memories alike stay where they belong – in the past where they happened. They don’t spend much time pining for the good ol’ days because they are too busy making new memories now. The negative pulls from the past are used not for self-flagellation or unproductive regret, but rather productive regret where they use lessons learned as stepping stones towards a better future.

4. Show me a positive person and I can show you a grateful person.

The most positive people are the most grateful people.  They do not focus on the potholes of their lives.  They focus on the pot of gold that awaits them every day, with new smells, sights, feelings and experiences.  They see life as a treasure chest full of wonder.

5. Rather than being stuck in their limitations, positive people are energized by their possibilities.

Optimistic people focus on what they can do, not what they can’t do.  They are not fooled to think that there is a perfect solution to every problem, and are confident that there are many solutions and possibilities.  They are not afraid to attempt new solutions to old problems, rather than spin their wheels expecting things to be different this time.  They refuse to be like Charlie Brown expecting that this time Lucy will not pull the football from him!

6. Positive people do not let their fears interfere with their lives!

Positive people have observed that those who are defined and pulled back by their fears never really truly live a full life. While proceeding with appropriate caution, they do not let fear keep them from trying new things. They realize that even failures are necessary steps for a successful life. They have confidence that they can get back up when they are knocked down by life events or their own mistakes, due to a strong belief in their personal resilience.

7. Positive people smile a lot!

When you feel positive on the inside it is like you are smiling from within, and these smiles are contagious. Furthermore, the more others are with positive people, the more they tend to smile too! They see the lightness in life, and have a sense of humor even when it is about themselves. Positive people have a high degree of self-respect, but refuse to take themselves too seriously!

8. People who are positive are great communicators.

They realize that assertive, confident communication is the only way to connect with others in everyday life.  They avoid judgmental, angry interchanges, and do not let someone else’s blow up give them a reason to react in kind.Rather, they express themselves with tact and finesse.  They also refuse to be non-assertive and let people push them around. They refuse to own problems that belong to someone else.

9. Positive people realize that if you live long enough, there are times for great pain and sadness.

One of the most common misperceptions about positive people is that to be positive, you must always be happy. This can not be further from the truth. Anyone who has any depth at all is certainly not happy all the time.  Being sad, angry, disappointed are all essential emotions in life. How else would you ever develop empathy for others if you lived a life of denial and shallow emotions? Positive people do not run from the gamut of emotions, and accept that part of the healing process is to allow themselves to experience all types of feelings, not only the happy ones. A positive person always holds the hope that there is light at the end of the darkness.  

10. Positive person are empowered people – they refuse to blame others and are not victims in life.

Positive people seek the help and support of others who are supportive and safe.They limit interactions with those who are toxic in any manner, even if it comes to legal action and physical estrangement such as in the case of abuse. They have identified their own basic human rights, and they respect themselves too much to play the part of a victim. There is no place for holding grudges with a positive mindset. Forgiveness helps positive people become better, not bitter.

How about you?  How many habits of positive people do you personally find in yourself?  If you lack even a few of these 10 essential habits, you might find that the expected treasure at the end of the rainbow was not all that it was cracked up to be. How could it — if you keep on bringing a negative attitude around?

I wish you well in keeping positive, because as we all know, there is certainly nothing positive about being negative!

(Photo credit: Positivity Amongst Negativity via Shutterstock)


Featured photo credit: Janaína Castelo Branco via



638 Primary Personality Traits from MIT

Positive Traits (234 = 37%)

  1. Accessible
  2. Active
  3. Adaptable
  4. Admirable
  5. Adventurous
  6. Agreeable
  7. Alert
  8. Allocentric
  9. Amiable
  10. Anticipative
  11. Appreciative
  12. Articulate
  13. Aspiring
  14. Athletic
  15. Attractive
  16. Balanced
  17. Benevolent
  18. Brilliant
  19. Calm
  20. Capable
  21. Captivating
  22. Caring
  23. Challenging
  24. Charismatic
  25. Charming
  26. Cheerful
  27. Clean
  28. Clear-headed
  29. Clever
  30. Colorful
  31. Companionly
  32. Compassionate
  33. Conciliatory
  34. Confident
  35. Conscientious
  36. Considerate
  37. Constant
  38. Contemplative
  39. Cooperative
  40. Courageous
  41. Courteous
  42. Creative
  43. Cultured
  44. Curious
  45. Daring
  46. Debonair
  47. Decent
  48. Decisive
  49. Dedicated
  50. Deep
  51. Dignified
  52. Directed
  53. Disciplined
  54. Discreet
  55. Dramatic
  56. Dutiful
  57. Dynamic
  58. Earnest
  59. Ebullient
  60. Educated
  61. Efficient
  62. Elegant
  63. Eloquent
  64. Empathetic
  65. Energetic
  66. Enthusiastic
  67. Esthetic
  68. Exciting
  69. Extraordinary
  70. Fair
  71. Faithful
  72. Farsighted
  73. Felicific
  74. Firm
  75. Flexible
  76. Focused
  77. Forecful
  78. Forgiving
  79. Forthright
  80. Freethinking
  81. Friendly
  82. Fun-loving
  83. Gallant
  84. Generous
  85. Gentle
  86. Genuine
  87. Good-natured
  88. Gracious
  89. Hardworking
  90. Healthy
  91. Hearty
  92. Helpful
  93. Herioc
  94. High-minded
  95. Honest
  96. Honorable
  97. Humble
  98. Humorous
  99. Idealistic
  100. Imaginative
  101. Impressive
  102. Incisive
  103. Incorruptible
  104. Independent
  105. Individualistic
  106. Innovative
  107. Inoffensive
  108. Insightful
  109. Insouciant
  110. Intelligent
  111. Intuitive
  112. Invulnerable
  113. Kind
  114. Knowledge
  115. Leaderly
  116. Leisurely
  117. Liberal
  118. Logical
  119. Lovable
  120. Loyal
  121. Lyrical
  122. Magnanimous
  123. Many-sided
  124. Masculine  (Manly)
  125. Mature
  126. Methodical
  127. Maticulous
  128. Moderate
  129. Modest
  130. Multi-leveled
  131. Neat
  132. Nonauthoritarian
  133. Objective
  134. Observant
  135. Open
  136. Optimistic
  137. Orderly
  138. Organized
  139. Original
  140. Painstaking
  141. Passionate
  142. Patient
  143. Patriotic
  144. Peaceful
  145. Perceptive
  146. Perfectionist
  147. Personable
  148. Persuasive
  149. Planful
  150. Playful
  151. Polished
  152. Popular
  153. Practical
  154. Precise
  155. Principled
  156. Profound
  157. Protean
  158. Protective
  159. Providential
  160. Prudent
  161. Punctual
  162. Pruposeful
  163. Rational
  164. Realistic
  165. Reflective
  166. Relaxed
  167. Reliable
  168. Resourceful
  169. Respectful
  170. Responsible
  171. Responsive
  172. Reverential
  173. Romantic
  174. Rustic
  175. Sage
  176. Sane
  177. Scholarly
  178. Scrupulous
  179. Secure
  180. Selfless
  181. Self-critical
  182. Self-defacing
  183. Self-denying
  184. Self-reliant
  185. Self-sufficent
  186. Sensitive
  187. Sentimental
  188. Seraphic
  189. Serious
  190. Sexy
  191. Sharing
  192. Shrewd
  193. Simple
  194. Skillful
  195. Sober
  196. Sociable
  197. Solid
  198. Sophisticated
  199. Spontaneous
  200. Sporting
  201. Stable
  202. Steadfast
  203. Steady
  204. Stoic
  205. Strong
  206. Studious
  207. Suave
  208. Subtle
  209. Sweet
  210. Sympathetic
  211. Systematic
  212. Tasteful
  213. Teacherly
  214. Thorough
  215. Tidy
  216. Tolerant
  217. Tractable
  218. Trusting
  219. Uncomplaining
  220. Understanding
  221. Undogmatic
  222. Unfoolable
  223. Upright
  224. Urbane
  225. Venturesome
  226. Vivacious
  227. Warm
  228. Well-bred
  229. Well-read
  230. Well-rounded
  231. Winning
  232. Wise
  233. Witty
  234. Youthful

Neutral Traits (292 = 18%)

  1. Absentminded
  2. Aggressive
  3. Ambitious
  4. Amusing
  5. Artful
  6. Ascetic
  7. Authoritarian
  8. Big-thinking
  9. Boyish
  10. Breezy
  11. Businesslike
  12. Busy
  13. Casual
  14. Crebral
  15. Chummy
  16. Circumspect
  17. Competitive
  18. Complex
  19. Confidential
  20. Conservative
  21. Contradictory
  22. Crisp
  23. Cute
  24. Deceptive
  25. Determined
  26. Dominating
  27. Dreamy
  28. Driving
  29. Droll
  30. Dry
  31. Earthy
  32. Effeminate
  33. Emotional
  34. Enigmatic
  35. Experimental
  36. Familial
  37. Folksy
  38. Formal
  39. Freewheeling
  40. Frugal
  41. Glamorous
  42. Guileless
  43. High-spirited
  44. Huried
  45. Hypnotic
  46. Iconoclastic
  47. Idiosyncratic
  48. Impassive
  49. Impersonal
  50. Impressionable
  51. Intense
  52. Invisible
  53. Irreligious
  54. Irreverent
  55. Maternal
  56. Mellow
  57. Modern
  58. Moralistic
  59. Mystical
  60. Neutral
  61. Noncommittal
  62. Noncompetitive
  63. Obedient
  64. Old-fashined
  65. Ordinary
  66. Outspoken
  67. Paternalistic
  68. Physical
  69. Placid
  70. Political
  71. Predictable
  72. Preoccupied
  73. Private
  74. Progressive
  75. Proud
  76. Pure
  77. Questioning
  78. Quiet
  79. Religious
  80. Reserved
  81. Restrained
  82. Retiring
  83. Sarcastic
  84. Self-conscious
  85. Sensual
  86. Skeptical
  87. Smooth
  88. Soft
  89. Solemn
  90. Solitary
  91. Stern
  92. Stoiid
  93. Strict
  94. Stubborn
  95. Stylish
  96. Subjective
  97. Surprising
  98. Soft
  99. Tough
  100. Unaggressive
  101. Unambitious
  102. Unceremonious
  103. Unchanging
  104. Undemanding
  105. Unfathomable
  106. Unhurried
  107. Uninhibited
  108. Unpatriotic
  109. Unpredicatable
  110. Unreligious
  111. Unsentimental
  112. Whimsical

Negative Traits (292 = 46%)

  1. Abrasive
  2. Abrupt
  3. Agonizing
  4. Aimless
  5. Airy
  6. Aloof
  7. Amoral
  8. Angry
  9. Anxious
  10. Apathetic
  11. Arbitrary
  12. Argumentative
  13. Arrogantt
  14. Artificial
  15. Asocial
  16. Assertive
  17. Astigmatic
  18. Barbaric
  19. Bewildered
  20. Bizarre
  21. Bland
  22. Blunt
  23. Biosterous
  24. Brittle
  25. Brutal
  26. Calculating
  27. Callous
  28. Cantakerous
  29. Careless
  30. Cautious
  31. Charmless
  32. Childish
  33. Clumsy
  34. Coarse
  35. Cold
  36. Colorless
  37. Complacent
  38. Complaintive
  39. Compulsive
  40. Conceited
  41. Condemnatory
  42. Conformist
  43. Confused
  44. Contemptible
  45. Conventional
  46. Cowardly
  47. Crafty
  48. Crass
  49. Crazy
  50. Criminal
  51. Critical
  52. Crude
  53. Cruel
  54. Cynical
  55. Decadent
  56. Deceitful
  57. Delicate
  58. Demanding
  59. Dependent
  60. Desperate
  61. Destructive
  62. Devious
  63. Difficult
  64. Dirty
  65. Disconcerting
  66. Discontented
  67. Discouraging
  68. Discourteous
  69. Dishonest
  70. Disloyal
  71. Disobedient
  72. Disorderly
  73. Disorganized
  74. Disputatious
  75. Disrespectful
  76. Disruptive
  77. Dissolute
  78. Dissonant
  79. Distractible
  80. Disturbing
  81. Dogmatic
  82. Domineering
  83. Dull
  84. Easily Discouraged
  85. Egocentric
  86. Enervated
  87. Envious
  88. Erratic
  89. Escapist
  90. Excitable
  91. Expedient
  92. Extravagant
  93. Extreme
  94. Faithless
  95. False
  96. Fanatical
  97. Fanciful
  98. Fatalistic
  99. Fawning
  100. Fearful
  101. Fickle
  102. Fiery
  103. Fixed
  104. Flamboyant
  105. Foolish
  106. Forgetful
  107. Fraudulent
  108. Frightening
  109. Frivolous
  110. Gloomy
  111. Graceless
  112. Grand
  113. Greedy
  114. Grim
  115. Gullible
  116. Hateful
  117. Haughty
  118. Hedonistic
  119. Hesitant
  120. Hidebound
  121. High-handed
  122. Hostile
  123. Ignorant
  124. Imitative
  125. Impatient
  126. Impractical
  127. Imprudent
  128. Impulsive
  129. Inconsiderate
  130. Incurious
  131. Indecisive
  132. Indulgent
  133. Inert
  134. Inhibited
  135. Insecure
  136. Insensitive
  137. Insincere
  138. Insulting
  139. Intolerant
  140. Irascible
  141. Irrational
  142. Irresponsible
  143. Irritable
  144. Lazy
  145. Libidinous
  146. Loquacious
  147. Malicious
  148. Mannered
  149. Mannerless
  150. Mawkish
  151. Mealymouthed
  152. Mechanical
  153. Meddlesome
  154. Melancholic
  155. Meretricious
  156. Messy
  157. Miserable
  158. Miserly
  159. Misguided
  160. Mistaken
  161. Money-minded
  162. Monstrous
  163. Moody
  164. Morbid
  165. Muddle-headed
  166. Naive
  167. Narcissistic
  168. Narrow
  169. Narrow-minded
  170. Natty
  171. Negativistic
  172. Neglectful
  173. Neurotic
  174. Nihilistic
  175. Obnoxious
  176. Obsessive
  177. Obvious
  178. Odd
  179. Offhand
  180. One-dimensional
  181. One-sided
  182. Opinionated
  183. Opportunistic
  184. Oppressed
  185. Outrageous
  186. Overimaginative
  187. Paranoid
  188. Passive
  189. Pedantic
  190. Perverse
  191. Petty
  192. Pharissical
  193. Phlegmatic
  194. Plodding
  195. Pompous
  196. Possessive
  197. Power-hungry
  198. Predatory
  199. Prejudiced
  200. Presumptuous
  201. Pretentious
  202. Prim
  203. Procrastinating
  204. Profligate
  205. Provocative
  206. Pugnacious
  207. Puritanical
  208. Quirky
  209. Reactionary
  210. Reactive
  211. Regimental
  212. Regretful
  213. Repentant
  214. Repressed
  215. Resentful
  216. Ridiculous
  217. Rigid
  218. Ritualistic
  219. Rowdy
  220. Ruined
  221. Sadistic
  222. Sanctimonious
  223. Scheming
  224. Scornful
  225. Secretive
  226. Sedentary
  227. Selfish
  228. Self-indulgent
  229. Shallow
  230. Shortsighted
  231. Shy
  232. Silly
  233. Single-minded
  234. Sloppy
  235. Slow
  236. Sly
  237. Small-thinking
  238. Softheaded
  239. Sordid
  240. Steely
  241. Stiff
  242. Strong-willed
  243. Stupid
  244. Submissive
  245. Superficial
  246. Superstitious
  247. Suspicious
  248. Tactless
  249. Tasteless
  250. Tense
  251. Thievish
  252. Thoughtless
  253. Timid
  254. Transparent
  255. Treacherous
  256. Trendy
  257. Troublesome
  258. Unappreciative
  259. Uncaring
  260. Uncharitable
  261. Unconvincing
  262. Uncooperative
  263. Uncreative
  264. Uncritical
  265. Unctuous
  266. Undisciplined
  267. Unfriendly
  268. Ungrateful
  269. Unhealthy
  270. Unimaginative
  271. Unimpressive
  272. Unlovable
  273. Unpolished
  274. Unprincipled
  275. Unrealistic
  276. Unreflective
  277. Unreliable
  278. Unrestrained
  279. Unself-critical
  280. Unstable
  281. Vacuous
  282. Vague
  283. Venal
  284. Venomous
  285. Vindictive
  286. Vulnerable
  287. Weak
  288. Weak-willed
  289. Well-meaning
  290. Willful
  291. Wishful
  292. Zany


Some things on this list crack me up.

 Stay healthy! Stay positive!

7 Keys to Happiness


Happiness and Health are like fraternal twins.

They are not identical, but they’re born at the same time.

They are interchangeable. If you feel healthy you feel happy.

If you feel happy, you’re more likely to feel healthy.


So what’s the key to happiness?  I can tell you that if you think it’s a destination as in, “I will be happy when I retire and move to Florida” or “I’ll be happy when I’m on vacation next week” –you will not be happy.

KEY #1:  HAPPINESS IS WHERE YOU ARE RIGHT NOW.  If you can be happy living in one room, you’ll be happy living in twenty.  If you’re not happy in one room, that will not change once the novelty of the twenty rooms wears off.

KEY #2:  FIND HUMOR IN TENSE SITUATIONS. Whenever you can’t control a situation, control how you react to it, which is essentially to not react to it. Respond with calmness, kindness, understanding, compassion or humor whenever you can.

KEY #3:  DON’T BE TENSE UNLESS YOUR HOUSE IS ON FIRE.   Even then, it’s the calm person more likely to get out safe.


This isn’t someone who lies, betrays, cheats, gossips or ignores. This is the non-judgmental son you can text: I tossed the garbage out in my robe and now I’m locked out at 3 a.m. friend who laughs first and then helps you figure out what to do next. Ok, maybe you need 3 friends like this.

KEY 5:  SURROUND YOURSELF WITH POSITIVE PEOPLE.  Refer back to #4. These are people who know life is rarely a straight line. The journey is filled with hills and valleys. Positive people genuinely find the best in every situation and see the best in everyone. They are slow to judge others and they don’t gossip because the other person isn’t there to present their side, and if you’re over the age of nine you know there is another side.

KEY #6:  MAKE HEALTHY CHOICES.   Buy healthy, stock up on healthy food and water, walk daily, drink lots of water, get enough sleep and fresh air and you will feel better.  Replace bad comfort foods with healthier ones.  Remember perfect is the evil of good. Educate yourself on what is nutritious. There is a search button on this blog where you can type in nutrition or food to pull up prior blogs on that.

KEY7:   KNOW THAT NO ONE FEELS HAPPY ALL THE TIME.  Accept the ebb and flow as natural. You’re human and will feel different emotions each day.  You manage your state of mind by managing all the above, so that your dominant state is one of calmness and contentment.  Think of a pleasant thought right now.  Smile to yourself.  Hold that thought. Your brain just registered that you are happy.   You’re the only one who owns your Happiness keys.  Use all your senses to pick up on things to be happy and grateful for: birds chirping, quiet, music, time to be reading this blog, eyesight to be reading this.

Tony Robbins says, “Change your EXPECTATIONS for yourself or others to APPRECIATION.”      Love that.





Sleep Habits of Geniuses






Tesla reportedly curled his toes 100 times on each foot before sleep, believing that stimulated brain cells.   Funny, I do that to warm up my Flintstone feet.


Charles Dickens carried a navigational compass with him at all times to ensure that he was always facing north while he slept. He believed that this practice improved his creativity and writing (and perhaps his ability to always know what direction he was facing at any given time).  [source: Ashlee Christian, FreelancersUnion]
Salvador Dalí thought sleep was for the birds, or you know for all the other organisms that actually need to sleep for more than one second at a time. He would nap in a chair with a key in his hand above a plate, and the second he fell asleep the key would fall, hit the plate, and wake him up. Similar to the Uberman cycle, it is a form of hypnagogic sleep that Dalí felt enhanced his creativity. [source: Ashlee Christian, FreelancersUnion]


Thank you Ashlee Christian for adding two women to the list. I’ll find more and add to the end. Actually, my siblings are going to have a laugh at this one.

Emily Brontë was plagued by insomnia and would walk circles around her dining room table until she fell asleep (presumably in a bed and not under the table, but who knows).


Flannery O’Connor slept from 9pm to 6am every day.  That’s a regular nine hours.

Photo by: Cmacauley























Charles Dickens carried a navigational compass with him at all times to ensure that he was always facing north while he slept. He believed that this practice improved his creativity and writing (and perhaps his ability to always know what direction he was facing at any given time).Salvador Dalí thought sleep was for the birds, or you know for all the other organisms that actually need to sleep for more than one second at a time.He would nap in a chair with a key in his hand above a plate, and the second he fell asleep the key would fall, hit the plate, and wake him up. Similar to the Uberman cycle, it is a form of hypnagogic sleep that Dalí felt enhanced his creativity.

It’s important to know how much sleep you need to be at your best and most productive.  For me, it’s 10 hours. People think I don’t sleep at all, when it’s actually the opposite.

I get ten hours, but it may be at odd times. For instance, if I’m working at a network from midnight to 8 a.m. I sleep from 9 a.m. to 7 p.m. and get on a bus at 8 p.m. to arrive 10 p.m.

If I’m dayside, I adjust time. If I’m on my own, as long as I get 10 hrs. in there somewhere, I’m good. If sleep is interrupted, multiple power naps come in handy, but they’re never a replacement for a good night’s sleep.

A lot of writers in history like Fran Kafka wrote from 10 p.m. to 3 a.m. and slept around that schedule.  Basically, if you work from home you can find when you’re most productive and be up then, but you have to make sure you work in 9 hours of sleep around it.

Today is National Nap Day.

These days are created to raise awareness, which begs the question about a lot of stupid ones out there.  I digress.  It’s today because you lost an hour of sleep yesterday when the clocks jumped forward, so you may feel sluggish today. Hence, National Nap Day to let you know it’s okay to close your door and take a nap today.

Good luck with that in open work environments. One sneeze and the whole team get sick.  Seriously, who came up with open work environments?  Collaborative?  That’s 2 or 3 people in one office, not an open zoo hearing everyone’s conversations or chewing gum, smelling cologne, perfume or food –the list can go on about how these people pretend to work and secretly can’t wait to get the heck out of there.

I can walk into any company and know if it’s a healthy office or team. The irony is some of them profess to be about health when they’re the Canal Street of Madison Avenue.  You can buy a fake watch, but as genius Steve Jobs learned, you can’t buy into anything fake when it comes to health.  I don’t know how many hour Jobs slept a night, but he was known to call designers up at 3 a.m.  My guess is he probably could have used someone with his best interests at heart advising him on healthy habits.  It’s so dangerous to get yes men or women or those trying to sell something around you when you’re successful or worse, those giving you misinformation.

I promised earlier I would find more women. OPRAH!  I already said I know she loves power naps, but I am curious how many hours of sleep she gets a night.  She reports she is at her best at 5 and a half hours of sleep each night. Oh no.  There you have it. That’s why she has had weight issues her whole life. Why hasn’t any expert told her this??  At that amount of sleep her body is releasing something called cortisol and it keeps the hunger gremlins turned ON, ON,  ON  all the time while causing inflammation in the body. Why didn’t Dr. Oz catch this?  Rest is critical to the body.  If she changed this ONE habit she will be amazed at the results.

The world needs people to rest. Less illness. People think when you have a million or a billion dollars you should sleep like a baby. NO!  Not true. Remember when you were a kid and you couldn’t sleep the night before Christmas because you were too excited?!  Well, having a billion dollars is initially like that. Then, stressors appear like competition, relationships, fake people suddenly inviting you to be a part of this or that event, dinner or organization just because you have money. You’ll wonder where these people were when you had no money. They are not your friends. When you realize the fakeness in all the fundraising and pay to play things out there you realize some things can not be bought. Everything real can not. True friendship.  True love.  True health. True happiness. Another thing happens when you have money. Friends without money can’t do everything you want to do because they don’t have money or free time. That’s where it’s lonely at the top come from. So, there is stress.  If a wealthy person or a poor person do not sleep enough the results are the same. They will both experience a rise in cortisol, the fear hormone which causes inflammation inside your body. Too many yes men or women or ill informed people around you really can cause you to be sick. Make sure you have a healthy reference group in your circle.


Let’s look at some other sleeping habits. Marissa Mayer reports 4 to 6 hours. Again, not good. Lordy, Martha Stewart reports 4 hours.

President Obama reports sleeping from 1 a.m. to 7 a.m.  That’s only 6 hours a night.

It’s so important the President be well-rested.  I bet whoever they put on the White House team for health writes prescriptions when someone can’t sleep instead of really caring and or knowing about health.

The world needs people who brag about getting a good night’s rest. The funny thing is it shows on their faces and bodies and ability to make good decisions.  I forgot to mention that the release of cortisol in your body also ages you faster. I know so much about cortisol, but this blog is about NAPPING and the sleeping habits of Geniuses, so will save that for another time.  Until then,  hope you’ve learned something that makes you healthier. It’s never too late to change a habit for the better.

When your basic daily habits are healthy you should only need to see your physician once a year to get a compete physical, and for recommended screenings for your age group. That’s when your doctor says, “Everything looks great. Keep doing whatever it is you’re doing.”

Happy National Power Napping! -Maria Dorfner


Genius inspiration favors the well-rested mind.



In honour of National Napping Day, Mark Molloy of UK Telegraph takes a look at some of the apparent benefits of taking some time out of your busy schedule to catch up on your sleep.

It could save your life

Napping could reduce blood pressure and stave off heart attacks, according to Greek researchers.

They found that those who had a nap at noon later had lower blood pressure than those who stayed awake through the day in a study involving almost 400 middle-aged men and women.

“Midday naps seem to lower blood pressure levels and may probably also decrease the number of required antihypertensive medic [drugs],” said Dr Manolis Kallistratos, the lead researcher.

Keeps you focused

Margaret Thatcher: enjoyed a nap  Photo: PA

Both Margaret Thatcher and Sir Winston Churchill knew about the benefits of having power naps to stay focused for longer at work.

Baroness Thatcher famously slept for just four hours a night during the week, though she took regular daytime naps.

Sir Winston Churchill managed on just four hours sleep a night during World War Two – but insisted on a two hour nap in the afternoon.

Scientist Albert Einstein reportedly slept for 10 hours a night, plus daytime naps.

Helps you feel more refreshed

Post-lunch power naps can be as refreshing as a good night’s sleep, according to a study.

Scientists have shown that a 60- to 90-minute siesta can charge up the brain’s batteries as much as eight hours tucked up in bed.

Boosts productivity

A specialist technical abseil team clean and inspect one of the four faces of the Great Clock, otherwise known as Big Ben, at the Houses of Parliament, in central London: Big Ben's clock gets big bath from abseiling cleanersResearch suggests you should make time for naps  Photo: PA

Bosses should let their staff take naps at work as sleeping for 30 to 90 minutes in the afternoon can improve creativity, a leading brain researcher claims.

“It’s best to give your brain downtime. I have a nap every afternoon,” explains Vincent Walsh, professor of human brain research at University College London.

“It’s only since the industrial revolution we have been obsessed with squeezing all our sleep into the night rather than having one or two sleeps through the day.”

Improves your mood

Toddlers who are denied regular afternoon naps grow up into grumpier and moodier adults, a study indicates.

US researchers found that toddlers who miss just one daytime nap become more anxious and less interested in the world around them.

Reduces stress

Spanish scientists believed they have proved a siesta is good for you and issued guidelines for the perfect nap.

A short sleep after lunch can reduce stress, help cardiovascular functions, and improve alertness and memory, according to the Spanish Society of Primary Care Physicians (SEMERGEN).

They suggest a siesta should be no longer than half an hour, others suggest it should not be longer than 15 minutes.

Reduces mistakes

Naps can restore alertness, enhance performance, and reduce mistakes and accidents, according to the National Sleep Foundation (NSA).

A study at NASA on sleepy military pilots and astronauts found that a 40-minute nap improved performance by 34 per cent and alertness 100 per cent, the NSA reports.

Meanwhile, this simple 10-3-2-1-0 formula could make your days more productive.

Sleep habits of those at the top

  • As Prime Minister, Margaret Thatcher famously slept for just four hours a night during the week, though she took regular daytime naps.
  • When asked how many hours sleep people need, Napoleon Bonaparte is said to have replied: “Six for a man, seven for a woman, eight for a fool.”
  • US President Barack Obama is understood to only sleep for six hours
  • Business magnate Donald Trump boasts just three to four hours sleep nightly.
  • Sir Winston Churchill managed on just four hours sleep a night during World War Two – but insisted on a two hour nap in the afternoon.
  • Scientist Albert Einstein reportedly slept for 10 hours a night, plus daytime naps.
  • Bill Gates, former chief executive of Microsoft, says he needs seven hours of sleep to “stay sharp”.




Maria Dorfner is the founder of NewsMD and Healthy Within Network.  This is her blog. Follow her on Twitter @Maria_Dorfner.  She can be reached at


“The people you spend time with determine your longevity.” -Daniel Amen, psychiatrist






In 2000, I practically lived at the Cleveland Clinic.  In fact, they wanted to put me up at a hotel, but I preferred to be closer to the patients I was writing stories about. One of those patients was dying from AIDS.  He was in the Palliative Care Unit. I spent time speaking to him, his partner, his family and his caretakers.

I’d been a professional health journalist since 1993, after working in media as a researcher, producer and writer for 10 years. I love covering health, studied it since I was a kid and covered it on college newspapers. I couldn’t afford to go to medical school, but think journalism ranks up there as one of the most important callings in the world.  We filmed a documentary on Palliative Care and it was an extremely touching story.

He was an in-patient, but his room was beautiful and he shared how comfortable he was knowing he had the best physicians around him and that family could visit any time.  We talked so comfortably about everything not even minding the camera in the room.  One day prior to it being released I got a call. The patient died.  His partner was devastated.  His partner thanked me for creating the most beautiful keepsake he had –the video.  Through his tears, he asked if I would refrain from airing it. It was something he and the patient had talked about prior to his passing away –that they would only want it to air if they could watch it together.  They knew the possibility existed that it would not happen.

I honored their wish.

The need for a healing touch continues even after a cure is no longer possible.

What is Palliative Medicine?

Palliative medicine is comprehensive medical care for patients with life threatening disease that focuses on control of cancer symptoms, management of complications, and quality of life. It cares for patients and their families and treats the cancer symptoms of body, mind and spirit. It is most successful when done with a multidisciplinary team approach to treating the cancer symptoms.

What are the goals of Palliative Medicine?

  • To provide excellent care of patients and their families dealing with advanced disease throughout the illness and during bereavement
  • To advocate effectively for patient comfort, dignity and choice

Who needs Palliative Medicine?

  • People experiencing pain or other cancer symptoms
  • People with ALS (Lou Gehrig’s disease), AIDS, heart failure, chronic lung disease or other serious illness experiencing symptoms or repeated hospitalizations
  • Patients or families dealing with the stress of a life threatening illness and cancer symptoms

What does a Palliative Medicine team do for my family and me?

We strive to help people live as well as they can despite their illness and to cope with cancer symptoms. We focus on controlling any cancer symptoms that may be interfering in the quality of life, defining goals for any subsequent treatment, and maintaining the best physical and emotional well-being possible despite complex problems. The medical specialist functions as the quarterback of a team, including the patient and the family in what can be difficult decisions. Family conferences are routinely held to ensure that everyone involved is aware of and involved in the plan of care.

Who is on the team?

  • The patient and the family
  • The referring physician
  • The palliative medicine physician
  • Registered nurses
  • Physician assistants
  • Dietitians
  • Social workers
  • Chaplains
  • Music and art therapist
  • Home health aides
  • Trained volunteers

What services are provided?

Cancer Symptom Control: There is no need for anyone to suffer from uncontrolled pain, nausea or dyspnea (shortness of breath). Medical science knows how to effectively control these cancer symptoms most of the time. Making sure this happens is one of the primary goals of this program.

Case Management: People with serious illness often have many doctors involved in their care making. It is difficult to determine who to contact when a problem occurs. In this program, each patient has a registered nurse case manager assigned. That person is then a link to all other caregivers and available after hours.

The Harry R. Horvitz Center: Most people can be managed in an outpatient setting, but in crisis, this 23-bed inpatient unit is available for comprehensive multidisciplinary care.

Inpatient Consultation Service: Comprehensive assessment and management of symptoms in other areas of the hospital is provided to ensure maximum comfort for all hospitalized patients. The attending physician must request this service.

Outpatient Clinic: Specialty follow-up and consultation are available in this clinic. Nurse case managers maintain contact with their patients in this setting also.

Home Care and Hospice: As people become more ill they may need assistance at home which can be provided by Cleveland Clinic Home Care Ventures. As end of life approaches, the Hospice of the Cleveland Clinic is available at home for the special multidisciplinary care so critical at this time of life. Inpatient hospice care in the community is also available. Continuity is maintained throughout with the staff of the Palliative Medicine Program.

What is special about the Harry R. Horvitz Center?

Dr. Declan Walsh first developed the program at the Cleveland Clinic in 1988. At that time nothing of its kind existed in the United States. It still remains one of the few fully integrated programs in this country. In 1991 it was recognized by the World Health Organization as “a unique model of a much needed service” and designated a WHO Demonstration Project. The program had the first endowed chairs in Palliative Medicine in the USA.

The 23-bed inpatient unit was built in memory of Harry R. Horvitz, lifelong resident of Cleveland, recognized by his friends and associates as a man of integrity and compassion. The unit consists of the following facilities:

  • 13 private patient rooms
  • 5 semi-private patient rooms
  • Family lounge
  • Glass enclosed solarium
  • Family dining room
  • Donor recognition area


The Harry R. Horvitz Center for Palliative Medicine also conducts important cancer research and educational programs in pain management, symptom control and nutrition. Donations made to the Harry R. Horvitz Center for Palliative Medicine are allocated for this vital research.

Advances made at the Cleveland Clinic have minimized unwanted side effects of treatment and enhanced quality of life for patients with advanced disease and painful cancer symptoms.

 Cancer Answers & Appointments

Speak with a cancer nurse specialist for appointment assistance and for answers to your questions about cancer locally at 216.444.7923216.444.7923 or toll-free 1.1.866.223.8100 FREE866.223.8100866.223.8100 FREE.

Monday through Friday from 8 a.m. – 4:30 p.m. (ET).


Resources for medical professionals

  • Outpatient appointment referrals: 216.444.7923216.444.7923 or 866.223.8100866.223.8100 FREE
  • Inpatient hospital transfers: 800.553.5056800.553.5056 FREE
  • Referring Physician Concierge: 216.444.6196216.444.6196 or 216.312.4910216.312.4910.

Clinical Trials

Search available cancer clinical trials by disease, hospital, phase or number.

This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

© Copyright 2016 Cleveland Clinic. All rights reserved.



Latino Youth In California See Significant Rise In Psychiatric Hospitalizations

February 24, 2016

Psychiatric hospitalizations of Latino children and young adults in California are rising dramatically — at a much faster pace than among their white and black peers, according to state data.

Nubia Flores Miranda, 18, at her home in Oakland, Calif., on Thursday, December 17, 2015. After participating in the mental health program at Life Academy of Health and Bioscience, Miranda decided to major in psychology at San Francisco State University. (Heidi de Marco/KHN)

While mental health hospitalizations of young people of all ethnicities have climbed in recent years, Latino rates stand out. Among those 21 and younger, they shot up 86 percent, to 17,813, between 2007 and 2014, according to the Office of Statewide Health Planning and Development. That’s compared with a 21 percent increase among whites and 35 percent among African Americans.

No one knows for certain what’s driving the trend. Policymakers and Latino community leaders offer varying and sometimes contradictory explanations. Some say the numbers reflect a lack of culturally and linguistically appropriate mental health services for Latinos and a pervasive stigma that prevents many from seeking help before a crisis hits.

“Often, they wait until they are falling apart,” said Dr. Sergio Aguilar-Gaxiola, a professor at the University of California, Davis Medical School and director of the university’s Center for Reducing Health Disparities.

Others blame stress from the recent recession, family disintegration and an influx of traumatized children fleeing poverty and violence in Central America.

Still others suggest the trend might actually be positive, reflecting an increasing willingness among Latino parents to seek treatment for themselves and their children, at least when they are in crisis.

Among Latino adults, psychiatric hospitalizations rose 38 percent during the same period. Similar hospitalizations of black adults increased 21 percent, while hospitalizations of white adults remained flat.

Margarita Rocha, the executive director of the nonprofit Centro la Familia in Fresno, said mental health issues are starting to be discussed more publicly in the Latino community.

“That’s helping people to come forward,” she said.

Miranda works part-time at Family Paths, a counseling and mental health organization in Oakland, Calif., on Friday, January 29, 2016. Miranda said she became interested in a career in mental health after she started experiencing depression and anxiety her freshman year at Life Academy of Health and Bioscience. (Heidi de Marco/KHN)

Ken Berrick, CEO of the Seneca Family of Agencies, which serves children with emotional disturbances in a dozen counties, agreed. Because more Latinos are now getting mental health services, children are more likely to be identified as requiring hospitalization, he said.

“I know for a fact that access to service is better now,” said Berrick, whose operation has a crisis stabilization unit in Alameda County, Calif.

Kids’ psychiatric hospitalizations overall rose nearly 45 percent between 2007 and 2014, regardless of ethnicity, a pattern experts attribute to various factors including a shortage of intensive outpatient and in-home services, schools’ struggles to pay for mental health services through special education and a decline in group home placements.

“Those kids have to be treated somewhere,” said Dawan Utecht, Fresno County’s mental health director, of the move to keep kids out of group homes.

“If they don’t get those services in a community setting, they’re going to go into crisis.”

The rise among Latino youths is remarkable in part because hospitalization rates for that population historically have been relatively low.

Latino children remain much less likely to receive mental health treatment through Medi-Cal, the state and federal coverage program for poor and disabled residents. Between 2010 and 2014, less than 4 percent of Latino children received specialty mental health services through the traditional Medi-Cal program. That’s compared with 7 percent of eligible black and white children, according to state data. The numbers don’t include those enrolled in managed care.

Eric Waters, coordinator for the behavioral health program at the Life Academy High School, leads a discussion with Fernanda May, 17, and Graciela Perez, 17, at La Clínica de la Raza in Oakland, Calif., on January 27, 2016. The program provides training in mental health first aid and places students in internships with mental health organizations. (Heidi de Marco/KHN)

(Asian Americans and Pacific Islanders seek treatment at a rate even lower than Latinos. Although hospitalizations are also increasing rapidly among that population, the raw numbers remain relatively small.)

Leslie Preston, the behavioral health director of La Clínica de La Raza, in East Oakland, says that the shortage of bilingual, bicultural mental health workers limits Latino kids’ access to preventive care, which could lead to crises later on.

“Everybody’s trying to hire the Spanish-speaking clinicians,” she said. “There’s just not enough clinicians to meet that demand.”

Access to care can be even harder for recent immigrants. Spanish-speaking children who have been referred for a special education assessment, which can help them become eligible for mental health services, sometimes wait months or years before someone tests them, she said.

“The families don’t know the system,” she added. “They don’t know their rights.”

Other clinicians point to relatively low health insurance coverage among Latinos, particularly those without legal status, and a cultural resistance to acknowledging mental illness.

Dr. Alok Banga, medical director at Sierra Vista Hospital in Sacramento, said some immigrant parents he encounters don’t believe in mental illness and have not grasped the urgency of their children’s depression and past suicide attempts. Many are working two or three jobs, he said. Some are undocumented immigrants afraid of coming to the hospital or having any interaction with Child Protective Services.

But the biggest problem, from his perspective, is the shortage of child psychiatrists and outpatient services to serve this population.

“The default course for treatment falls on institutions: hospitals, jails and prisons,” he said.

Jeff Rackmil, director of the children’s system of care in Alameda County, said sheer population growth — particularly, an increase in Latino children insured under Medi-Cal — may also be part of the explanation for the rise in hospitalizations.

Yet the state’s Latino population aged 24 and under increased less than 8 percent between 2007 and 2014, which doesn’t nearly explain an 86 percent increase in hospitalizations.

Elizabeth Ochoa, 17, and Victor Ramirez, 17, work on an assignment during their behavioral health training. The East Oakland students walk to the center from the nearby high school. (Heidi de Marco/KHN)

Some California communities are working to bring more Latino children into care and to reduce the stigma associated with mental illness.

At Life Academy of Health and Bioscience, a small, mostly Latino high school in East Oakland, students grow up amid pervasive violence and poverty. “We’re just told to hold things in,” said 17-year-old Hilda Chavez, a senior.

Students often don’t seek help because they fear discussing mental health problems will earn them a label of “crazy,” Chavez said.

Last year, the school, in conjunction with the Oakland-based La Clínica de La Raza, started a program to interest students in careers in mental health care. The program provides training in “first aid” instruction to help people in crisis, and places students in internships with mental health organizations.

Nubia Flores Miranda, 18, participated in the program last year and now is majoring in psychology at San Francisco State University. Miranda said she became interested in a career in mental health after she experienced depression and anxiety during her freshman year at Life Academy.

Seeing a school counselor “changed my life around,” she said.

But she saw that her peers were wary of seeking help from counselors at the school, most of whom were white and lived in wealthier, safer neighborhoods. Once, when a classmate started acting out at school, Miranda suggested she talk to someone.

“She told me she didn’t feel like she could trust the person — they wouldn’t understand where she was coming from,” she said.

Graciela Perez, 17, and Nayely Espinoza, 17, hold up their group assignment during a class presentation. The students are preparing for their mental health internships. (Heidi de Marco/KHN)

The shortage of services is especially evident in the Central Valley, where many agricultural workers are Latino. Juan Garcia, an emeritus professor at California State University, Fresno, who founded a counseling center in the city, says the drought and economic downturn have exacerbated depression, anxiety, substance abuse and psychotic breaks among Latinos of all ages.

“The services to this population lag decades behind where they should be,” he said.

In Fresno County, psychiatric hospitalizations of Latino youth more than tripled, to 432, between 2007 and 2014. Hospitalizations of their white and black peers about doubled.

Liliana Quintero Robles, a marriage and family therapy intern in rural Kings County, also in the state’s Central Valley, said she sees children whose mental health issues go untreated for so long that they end up cutting themselves and abusing alcohol, marijuana, crystal meth and OxyContin.

“There’s some really, really deep-rooted suffering,” she said.

Out in the unincorporated agricultural community of Five Points, about 45 minutes from Fresno, almost all of the students at Westside Elementary School are low-income Latinos. When principal Baldo Hernandez started there in 1981, he’d see maybe one child a year with a mental health issue. These days, he sees 15 to 30, he said.

He blames dry wells and barren fields, at least in part.

“I’ve had parents crying at school, begging me to find them a home, begging me to find them a job,” he said.

In some parts of the Valley and other places, the closest hospitals that accept children in psychiatric crises are hours away. Children can be stuck in emergency room hallways for days, waiting for a hospital bed.

“It makes for a very traumatized experience for both families and children,” said Shannyn McDonald, the chief of the Stanislaus County behavioral health department’s children’s system of care.

Recently, the county expanded its promotora program, which enlists members of the Latino community to talk to their peers about mental health.

In the small town of Oakdale, a slim, energetic 51-year-old promotora named Rossy Gomar spends 60 to 70 hours a week serving as cheerleader, educator and sounding board for many of the Latino women and children in the town.

Hilda Chavez, 17, at La Clinica de la Raza, says students at her high school don't really discuss mental health problems. Chavez says participating in the program has made her consider a career in behavioral health. (Heidi de Marco/KHN)

Gomar’s office in the Oakdale Family Support Network Resource Center is cluttered with open boxes of diapers and donated children’s toys and clothing.

“Look at my office,” she laughs. “We don’t fit.”

Gomar says many of the women she works with don’t recognize that they are depressed or abused. Children see their parents’ problems and don’t know where to turn for help.

“There are many young people who don’t have any hope,” she said.

But little by little, she has seen some good results.

One 17-year-old client is a student at Oakdale High School. The girl, whose name is being withheld to protect her privacy, said that earlier this year, problems at school and a break-up with her boyfriend had her struggling to get out of bed each morning. She began drinking, using drugs and thinking about suicide. She was scared to talk to her parents, she said, and kept everything inside.

One day, she walked into Gomar’s office and started crying.

“She told me ‘Everything is ok. We want you here,’” the girl said. “When I was talking with her, I felt so much better.”

The California Wellness Foundation supports KHN’s work with California ethnic media.


7 Tips to Live Agelessly by Dr. Adonis


1- Hydrate: 1 liter a day for each 50 lbs. of body weight.


2- Stay Active: Not necessarily the gym but active during the day: use a stand-up desk (500 calories extra a day burned), use the stairs, park far away


3- Sleep enough and Relax often. Avoid TV before sleeping especially violent movies and negative news. Meditate daily, even for 10 min.


4- Deep breathing. Yoga Pranayama or simply deep breaths often during the day.


5- Eat mostly greens. “Blue Zones” longevity communities around the world eat mostly vegetables and sparingly meats. Avoid processed meats (salami, etc). Eat “super foods” like blue-green algae.


6- Take nutraceuticals, anti-oxidants like Resveratrol and Omegas. Also take Vitamin D and Probiotics.


7- Replace hormones using bio-identical hormones once they start to be low in laboratory tests (Testosterone, Human Growth Hormone, Pregnenolone, Estrogens, DHEA and others)


GUEST AUTHOR, Adonis Maiquez, M.D. is Board Certified in Anti-Aging and Regenerative Medicine*, with a special interest in the neuro-endocrine theory of aging.


As an active member of the American Academy of Anti-Aging Medicine( he is continually incorporating all the new advances, research and evidence-based medicine available.


He is also the author of The Function Medicine Handbook, Modern Medicine for Modern Times.


“Multiple factors influence our health and a combination of aging- oriented diet,supplements,hormone replacement therapy (HRT) with Bio-Identical Hormones,exercise and lifestyle modifications will have an impact on how and when we age.” -Dr. Adonis

Great tips.  For More Information or to Contact Dr. Adonis call:  (305) 624-0009.


Stay healthy, everyone!  🙂

  md1    MARIA DORFNER is the CEO and founder of
Healthy Within Network and NewsMD Communications, LLC.  This is her blog.

Medical/Health Stories/Tips?  She can be reached at


Keep Your Teeth Healthy As You Age!


Fortunately, my family won the genetic lottery when it comes to teeth. My parents both have perfect smiles and good health.


And some say I have a trillion dollar smile.  But what happens to our smiles as we age?


Does everyone’s teeth eventually fall out?


Most people assume losing teeth are a natural part of aging. Not so. Adult teeth don’t fall out from natural causes.  Repeat.


Five things cause teeth to fall out:  1. Trauma 2. Severe illness (diabetes, cancer, osteomyelitis or autoimmune diseases)


3. Gum disease 4. Lifestyle, what you eat and drink along with your oral hygiene and 5. Drugs such as heroin and methamphetamine (also called speed, ice or meth), cocaine, crack cause severe tooth decay and teeth falling out in a very short amount of time.


Things that are harmful for your teeth include:  acidic foods and drinks like soda, some mouth fresheners, some tooth whiteners and a lack of vitamin C and K. Foods high in sugar (sweets) and carbs can also cause tooth decay. See your dentist if your gums bleed or you feel any pain or sensitivity, as that may be an early warning sign of gum disease.  It’s worth it to keep an annual cleaning and checkup appointment.


Teeth begin to age and shift in your mid-20s. In your 30s, you start to lose bone, which makes gums recede.


In your 40s and 50s, top teeth will appear shorter as the lower teeth shift. Chewing, grinding and stress all affect your teeth. Women in perimenopause and menopause will have more stress than usual due to sleep problems as will men with high levels of stress.


A lot of stress goes to people’s jaws, which causes grinding and pressure on back teeth. Tooth grinding is also known as bruxism and can cause chipped, fractured and worn tooth enamel or increased sensitivity –even headaches.


If you have stress in your life, try to alleviate it with getting rest, exercise and fresh air. You can also get fitted for a night guard. This prevent clenching or grinding your teeth in your sleep.  It’s pricey, so you may want to try eliminating any stressors first.


Surprising new information from a recent issue of the Journal of Dental Research indicates seniors who sleep in dentures are at higher risk of developing pneumonia as bacteria from the mouth can be inhaled into the lungs.


The American Dental Association warns bacteria allowed to linger in the mouth can cause tooth decay, gum disease and tooth loss.


If you want to keep your natural teeth forever, it’s important to take care of them now.


There is a higher risk of dental disease leading to other health problems as we age.


Seniors may need to enlist family members and other loved ones to assist with dental hygiene.


The ADA encourages caregivers, whether the seniors are at home or in a nursing home, to supervise or aid in maintaining seniors’ dental health by making sure they brush twice a day, floss once a day, eat a healthy diet and visit the dentist regularly.


Hearing impairment is common among seniors.


For this reason, a caregiver can play an important communications role between a senior and the dentist by helping them prepare questions prior to their dental appointment.


Dentists providing written instructions helps in communicating with seniors too.


The ADA provides dental health tips for seniors and their caregivers


Judith Jones, DDS, from the American Dental Association is the director of the Center for Clinical Research at the University Goldman School of Dental Medicine in Boston. She is also a published researcher and serves on the editorial boards of The Journal of the American Dental Association.


Turns out, the same advice dentists gave you when you were a kid still holds true when you’re a senior.


BRUSH TWICE A DAY (Rinse with water anytime you eat)


FLOSS ONCE A DAY (My favorite are floss toothpicks. Portable and super easy to use)


EAT HEALTHY (Best foods for teeth are apples, cheese, yogurt, foods high in calcium)




Click here for Dr. Judith Jones answers to the following questions:

•What are some specific oral health concerns of older Americans?
•What can caregivers do to help seniors maintain their dental health?
•Why is it important for people with dentures to visit their dentist?
•Are there any dental products that are particularly suited for the needs of older people?

Dr. Jones offers the following Dental Tips for caregivers:

Encourage seniors to:

  • Use an electric toothbrush twice a day with a fluoride toothpaste
  • Use an interdental cleaner to floss teeth once  day
  • Eat a healthy diet
  • Tell dentist if they develop dry mouth, which can lead to tooth decay
  • Clean gums daily and remove dentures at night if they wear them



For More Information including the ADA® Find-a-Dentist™ tool:



MANI1       MARIA DORFNER is the founder of MedCrunch.



peggysuefilmquoteMEDCrunch is a division of Healthy Within Network (HWN).

Nutrition & Breast Cancer


Good nutrition may reduce the incidence of breast cancer and the risk of breast cancer progression or recurrence. There are many studies in progress to help further understand how diet and cancer are related. We do know, however, that improved nutrition reduces risk of chronic diseases, such as diabetes, obesity, hypertension and heart disease, and also enhances overall quality of life. It is estimated that one third of cancer deaths in the U.S. can be attributed to diet in adulthood [1].

Here are comprehensive guidelines from Natalie Ledesma, MS, RD, CSO and Ida and Joseph Friend Cancer Resource Center, UCSF Helen Diller Family Comprehensive Cancer Center and the University of California, San Francisco.

Guidelines for a Healthy Diet

o Plenty of fruits and vegetables

o High fiber – whole grains and beans/legumes

• Low fat diet with emphasis on healthy fats

• Limit processed and refined grains/flours/sugars

• Drink plenty of fluids

• Be physically active to help achieve and maintain a healthy weight


Plant based diet

A lifelong commitment to a plant based diet may lower a woman’s risk of developing breast cancer

and may also reduce the risk of recurrent breast cancer. A plant based diet consists primarily of fruits,

vegetables, whole grains, beans/legumes, and other plant protein sources.

* All words noted with an asterisk ( * ) are defined in the glossary

SHINE ON:  Foods for Healthy, Glowing Skin

Fill your plate with approximately

50% vegetables, 25% protein,

and 25% whole grain.



Contain vitamins, minerals, fiber, and various cancer-fighting phytonutrients* (for example: carotenoids, lycopene, indoles, isoflavones, flavonols).

• Vibrant, intense COLOR is one indicator of phytonutrient* content.

• There is extensive and consistent evidence that diets high in fruits and vegetables are associated

with decreased risks of many cancers, and while results for breast cancer risk are not yet conclusive,

they are promising [2-12].

• In a study of about 3000 postmenopausal women, a protective effect for vegetables was observed [2].

SHINE ON:  Foods for Healthy, Glowing Skin

o Women who consumed 25 or more servings of vegetables weekly had a 37% lower risk of

breast cancer compared with women who consumed fewer than 9 vegetable servings weekly.


• An epidemiological study reported a significant protective effect of vegetables against breast cancer

when case-control* and cohort* studies were considered together [4].

• A meta-analysis* – looking at the data from 17 studies [13] revealed that high vs. low vegetable

consumption was associated with a 25% reduction in breast cancer risk, but these findings were not

confirmed by collected data from 8 studies [14].

• A recent case-control* study reported women who consumed more than 3.8 servings of fruits and

vegetables daily had a lower risk of breast cancer when compared with women who consumed

fewer than 2.3 daily servings [15].

• Japanese women following a prudent dietary pattern (high in fruits and vegetables, low in fat) had a

27% decreased risk of breast cancer [5].

• A Korean case-control study* reported that a high intake of certain fruits and vegetables resulted in

a significantly lower risk of breast cancer in premenopausal (tomatoes) and postmenopausal women

(grapes and green peppers) [6].

• While no effect was observed for vegetables, increasing total fruit intake significantly lowered the risk

of breast cancer when comparing those in the highest to lowest tertile [16].


o This effect was greater for those with estrogen-receptor positive (ER+) tumors.

• Eating a salad vegetable dietary pattern (high consumption of raw vegetables and olive oil) exerted a

significant protective effect against HER-2-positive cancers [10].

• A study assessing plasma or blood carotenoids as a marker for fruit and vegetable intake reported

that individuals in the top 1/4 had a 43% lower risk of breast cancer recurrence when compared to

those in the lowest 1/4 [17].

• However, no association was observed between fruit and vegetable consumption and breast cancer

recurrence when women consumed five servings daily vs. eight servings daily [18].

• Breast cancer survivors significantly reduced mortality by following a diet low in fat, high in

vegetables, high in fiber, and high in fruit [19].

• The combination of consuming five or more daily servings of vegetables and fruits, and accumulating

540+ metabolic equivalent tasks-min/wk (equivalent to walking 30 minutes 6 d/wk) decreased

mortality by nearly 50% [11].

o The effect was stronger in women who had hormone receptor-positive cancers.

• Vegetable intake has been inversely associated with serum insulin-like growth factor-I (IGF-I) levels [20].



• Beta-carotene is one of the 600 carotenoids that can be partially converted into vitamin A in the body.

• Carotenoids have a protective role for certain sites of cancer, including breast cancer [7, 21-24].

• Carotenoid intake was significantly associated with reduced mortality in breast cancer survivors [19].

• In various studies, serum beta-carotene levels were lower among breast cancer patients compared

to women without cancer [21,25-29].


o One of these studies reported the risk of breast cancer to be 221% greater for women in the

lowest quartile of serum beta-carotene compared to women in the highest quartile [29].

• A case-control* study reported that increased plasma levels of beta-carotene, retinol, and total

antioxidant* status were associated with about a 50% reduced risk of breast cancer [28].

• In vitro research indicates that carotenoids may inhibit the production of breast cancer cells [30-31].

o Beta-carotene may inhibit ER+ and estrogen-receptor negative (ER-) breast tumor development


• Beta-carotene may hinder the development of breast cancer cells by inducing apoptosis*, or

programmed cell death [32].

• Research indicates that dietary sources of beta-carotene are likely much more protective than

supplemental sources against the risk of cancer [33-35].

o Women who consumed higher amounts of dietary beta-carotene, lycopene, and betacryptoxanthin

were associated with a lower risk of breast cancer among Chinese women [23].

o Dietary alpha-carotene, beta-carotene, and lycopene were inversely associated with risk of

ER+PR+ breast cancer [24].

o Dietary beta-carotene intake was inversely associated with IGF-I levels in a large case-control

study [20].


Cruciferous Vegetables

• Some evidence suggests that the cruciferous vegetables, in particular, are associated with a

reduced risk of breast cancer [36-40].

• A Swedish study of postmenopausal women reported one to two daily servings of cruciferous

vegetables to reduce the risk of breast cancer, possibly by as much as 20-40% [37].

• Women who ate more turnips and Chinese Cabbage, in particular, significantly reduced the risk of

postmenopausal breast cancer [40].

• Consumption of cruciferous vegetables, particularly broccoli, was inversely, though not statistically

significant, associated with breast cancer risk in women [36].

• The U.S. component of the Polish Women’s Health Study found that women who consumed raw- or

short-cooked cabbage and sauerkraut 3 or more times weekly had a significantly reduced risk of

breast cancer [39].

o Cabbage that was cooked for a long time had no effect on breast cancer risk.

o Researchers suggested that glucosinolates, compounds in cabbage, may affect both the

initiation phase of carcinogenesis*, cell mutation*, and inhibit apoptosis*.

• Cruciferous vegetables appear to shift estrogen metabolism in a favorable manner; increasing

2-hydroxyestrone:16-a-hydroxyestrone [41-42]. Fowke and colleagues [42] concluded that

consuming more cruciferous vegetables across the population may very well have an impact on the

incidence of breast cancer.

• Several studies suggest that compounds found in these foods, isothiocyanates (sulforaphane), have

inhibitory effects on breast cancer cells in both cell studies and animal studies [38, 43, 44].

o One mechanism appears to be through potent inhibition of phase I and induction of phase II

detoxifying enzymes, such as glutathione-s-peroxidase [36,40,43].

o Furthermore, these compounds exhibited reduced cell proliferation and inhibited

cyclooxygenase-2 (COX-2) expression in breast cancer cells [45].

o Inhibited cell growth and induced apoptosis has also been observed [46].

• Indole-3-carbinol (I3C) is a compound found in cruciferous vegetables that has anticancer

properties and anti-proliferative effects on breast cancer cells [47].

o I3C may inhibit the growth of blood vessels that the tumor needs to grow (anti-angiogenesis)


• I3C and diindolylmethane (DIM) induce apoptosis*, or cell death, in breast cancer cells [41,49] for

both ER+ and ER- tumor cells [50].

• Furthermore, I3C and tamoxifen have been shown to act separately and/or cooperatively to inhibit

the growth of ER+ breast cancer cells [51].

• Dietary I3C may have effects that bolster immune function [52].

• Calcium-D-glucarate has been shown to inhibit beta-glucuronidase, an enzyme involved in phase

II liver detoxification. Elevated beta-glucuronidase activity is associated with an increased risk for

various cancers, particularly hormone-dependent cancers such as breast cancer [53].

Nutrient Dietary Sources Recommendation


Carrots, sweet potatoes, winter squash, cantaloupe, and mango.

Include these fruits and vegetables daily.


Cruciferous vegetables

Arugula, broccoli, Brussels sprouts,

cabbage, cauliflower, collard greens,

horseradish, kale, kohlrabi, mustard

greens, radishes, rutabaga, turnips

and turnip greens, and watercress

Include these vegetables daily.


Organic Produce

• Organic fruits and vegetables have fewer pesticides, lower levels of total pesticides, and less overall

pesticide toxicity than fruits and vegetables grown with chemicals. Although more research is

needed, recent evidence indicates a significant increase in antioxidants* in organic and sustainably

grown foods versus conventionally grown foods [54-58].

o Organic vegetables contained a greater concentration of phytonutrients* (phenolic acids) when

compared to conventionally grown vegetables [57,58].

• Consuming organic foods appears to increase salicylic acid, which may contribute to a lower risk of

cancer [57].

• Pesticides such as organochlorine compounds (OCC), known as environmental pollutants, have

been implicated in the etiology of estrogen-related disorders due to their potential estrogenic and

anti-estrogenic properties [59].

• Results of some studies [59-61], but not all [62] suggest that environmental exposure to

organochlorine pesticide residues or PCBs may contribute to multifactorial pathogenesis of breast



o In a study of women living on Long Island, New York, breast cancer risk was associated with

lifetime residential pesticide use [63].

o Organochlorine pesticide residues, including DDTs and HCHs, may increase women’s risk of

breast cancer, particularly in premenopausal women in China [60].

o Exposure to beta-HCH, an organochlorine pesticide residue, both accelerated the appearance

and incidence of breast cancer tumors when compared to control mice [61].

• The level of exposure may be integral in determining the effects of these OCC.

o One study found that when breast adipose tissue reached levels higher than 2600 ppb, women

with postmenopausal ERalpha-positive breast cancer exhibited high proliferation [64].

• Choosing organic produce will help you reduce your levels of pesticide exposure and will most likely

increase your phytonutrient* consumption.

o Although washing and peeling your non-organic fruits or vegetables may help to reduce

pesticide residues, it will not eliminate them.


• Listed below are produce with the most and least pesticide contamination, both in terms of number

of pesticides used and the level of pesticide concentration on an average sampling. Thus, for the

fruits and vegetables shown on the most contaminated list, it is wise to buy organic. Alternatively, if

organic choices are not available, you may want to consider substituting with produce that tends to

contain the least amount of pesticides.


Produce most contaminated by pesticides: Produce least contaminated by pesticides:

Peaches Onions

Apples Avocado

Bell peppers Sweet corn

Celery Pineapples

Nectarines Mango

Strawberries Sweet peas

Cherries Asparagus

Lettuce Kiwi

Grapes–imported Bananas

Pears Cabbage

Spinach Broccoli

Potatoes Eggplant

**Adapted from Environmental Working Group – A Shopper’s Guide to Pesticides in Produce


It is most important, however, to eat fruits and vegetables – organic or conventional. If the

availability or cost of organic produce is a barrier, you may wish to avoid those fruits and vegetables

that have the highest pesticide residue content.

Pomegranate (Punica granatum; Punicaceae)

• Various parts of the pomegranate fruit (for example: seed oil, juice, fermented juice and peel extract)

have expressed the suppressive effects on human breast cancer cells in laboratory research [65].

• Pomegranate seed oil and fermented juice block the cancer cells’ oxygen supply, slow cell growth,

and promote cell death [66].

• Fermented pomegranate juice polyphenols* appear to have twice the anti-proliferative effect as

fresh pomegranate juice polyphenols* [67].

• Furthermore, one study suggests that pomegranate seed oil may have the greatest preventive

activity (87% reduction in lesions) compared to fermented pomegranate juice (42% reduction) [68].



• A diet rich in natural fiber obtained from fruits, vegetables, legumes (for example: lentils, split peas,

black beans, pinto beans), and whole-grains may reduce cancer risk and/or reduce risk of cancer


• Fiber binds to toxic compounds and carcinogens, which are then later eliminated from the body [69].

• Various mechanisms have been proposed for the protective effects of dietary fiber against cancer.

These include:

o Increased fecal bulk and decreased intestinal transit time, which allow less opportunity for fecal

mutagens to interact with the intestinal epithelium [70].

o Binding to bile acids, which are thought to promote cell proliferation [71].

o Fermentation in the gut, producing short-chain fatty acids (SCFA). SCFA improve the gut

environment and may provide immune protection beyond the gut [70,71].

o Additionally, whole grains are rich in antioxidants*, including trace minerals and phenolic

compounds, which have been linked to disease prevention [71].

• Furthermore, a high fiber diet works to reduce hormone levels that may be involved in the

progression of breast cancer [70,72-75].

o A high-fiber, low-fat diet intervention found that fiber reduced serum estradiol* (estrogen breaks

down into estradiol* in the body) concentration in women diagnosed with breast cancer, the

majority of whom did not exhibit weight loss. Thus, increased fiber intake was independently

related to the reduction in serum estradiol* concentration [74].

o This decrease in estrogen levels in the blood thereby may potentially reduce the risk of

hormone-related cancers, such as breast cancer.

o Reduced levels of serum estrone* and estradiol* were observed in premenopausal women with

a greater intake of dietary fiber [73].

o Similarly, a high intake of dietary fiber was significantly associated with low serum levels of

estradiol in postmenopausal breast cancer survivors [75].

o Dietary fiber intake increases the amount of estrogen excreted in the stool [76].

• A high fiber diet is also associated with less obesity [72].

• Total dietary fiber intake, particularly from cereals and fruit, was found to significantly reduce the

risk of breast cancer in pre-menopausal, but not post-menopausal women [77].

• A recent cohort* study reported that high fiber intakes were associated with a 42% lower risk of

postmenopausal breast cancer, when comparing women in the highest quintile of fiber intake

compared to the lowest quintile [78].

An earlier prospective cohort* study, however, reported no protective effect of fiber against breast

cancer when comparing women who consumed fewer than 26 grams dietary fiber compared to

those who consumed even less [79]. This finding is not surprising given that the total grams of fiber

consumption was less than 30 grams.

o Similarly, another study that reported no significant findings compared women consuming less

than 25 grams fiber daily [80].

• Overall, case-control* studies have reported the greater the fiber intake, the lower the incidence of

breast cancer [8,81-84]. Data from prospective studies is mixed, reporting protective effects [78,85]

or no effect observed [79,80].

• Women who ate beans and lentils at least twice a week had a 24% lower risk of developing breast

cancer than women who ate them less than once a month [86].


High-Fiber Sources


Food Serving Size Fiber Grams/ Serving

Apple 1 medium 3.7

Banana 1 medium 2.8

Blackberries 1/2 cup 1.9

Blueberries 1 cup 1.3

Cantaloupe 1/2 cup 6.0

Figs (dried) 1/4 cup 6.0

Grapefruit 1 medium 3.4

Grapes 1 cup 1.6

Guava 1 medium 4.9

Kiwi 1 medium 2.6

Orange 1 medium 3.1

Pear 1 medium 4.0

Persimmon 1 medium 6.0

Prunes 1/4 cup 3.1



Food Serving Size Fiber Grams/ Serving

Amaranth 1/4 cup dry 7.4

Barley 1/2 cup cooked 3.0

Beans, black 1/2 cup cooked 8.3

Beans, red kidney 1/2 cup cooked 8.2

Beans, garbanzo 1/2 cup cooked 5.0

Bran cereals 3/4 cup Check labels (5.0-22.0)

Brown rice 1/2 cup cooked 1.4

Bulgur 1/2 cup cooked 4.0

Cream of wheat 1/2 cup cooked 0.5

Oatmeal 1/2 cup cooked 2.0

Peanuts 1/4 cup 2.9

Quinoa 1/4 cup dry 2.5

White rice 1/2 cup cooked 0.3



Food Serving Size Fiber Grams/ Serving

Artichokes 1 medium 6.9

Beets 1/2 cup cooked 1.7

Broccoli 1/2 cup cooked 2.3

Brussel sprouts 1/2 cup cooked 2.0

Carrots 1/2 cup cooked 2.6

Kale 1/2 cup cooked 1.3

Lima beans 1/2 cup cooked 4.5

Peas, green 1/2 cup cooked 4.4

Spinach 1/2 cup cooked 2.2

Squash, winter-type 1/2 cup cooked 3.4

Sweet potatoes (yams) 1/2 cup cooked 2.7



• High sugar foods are usually highly processed and refined, low in nutrient value, and also low in

dietary fiber. In addition, these foods appear to increase serum insulin* and serum IGF-I levels [87],

which appear to stimulate cancer cell growth.

o Overexpression, or high amounts, of IGF increases mammary tumors in mice [88].

o IGF’s may work by stimulating cell cycle progression & prevent cells from premature death [89-92].

o IGF-I may promote tumor growth via upregulation of ovarian steroid secretion [92,93].

o Research indicates a synergistic effect between IGF-I and estrogen [94] as well as IGF-I and

insulin* resistance [95] in breast cancer.

• A prospective cohort* study observed a significant 310% increased risk of breast cancer in

premenopausal women who had the highest quartile of IGF-I compared to women with the lowest

quartile [88].

o A weaker association was found with fasting insulin* levels where premenopausal women in the

two highest quartiles had a 70% greater risk for breast cancer.

o In premenopausal women, women in the highest quartile of serum glucose had a 280%

increased risk of breast cancer compared with women in the lowest quartile.

o In postmenopausal women, the associations of glucose, insulin*, and IGF-I were associated

with breast cancer risk in heavier subjects (BMI>26 1).

o Overall, these findings indicate that chronic change of glucose/ sugar metabolism is related to

breast cancer development.

• Other studies support a stronger link between IGF-I and breast cancer in premenopausal women


• Additionally, a case-control* study in China found that IGF-I significantly increased the risk of breast

cancer [95].

• Nonetheless, a recent meta-analysis* review of 18 studies reported no overall statistically significant

association between circulating IGF-I levels and risk of breast cancer although the levels were

greater in breast cancer patients than controls [90].

o However, IGF-I levels did appear to increase breast cancer risk in premenopausal women by

almost 40%.

• Similarly, a large prospective trial reported IGF-I significantly increased risk of breast cancer

in premenopausal women under the age of 50; no significant relationship was noted for

postmenopausal women [97].

• While not all studies [98] agree, a cohort* study reported that higher insulin* levels significantly

increased risk of breast cancer for both pre- and post-menopausal women [99].


• Recent studies indicate that high insulin* levels, increased concentration of IGF-I, and greater

abdominal fat are associated with increased risk for breast cancer [100].

• It has been suggested that decreasing IGF-I levels may be one factor that contributes to

tamoxifen’s anti-tumor activity in breast cancer therapy [101].

•Research is inconsistent regarding the association of IGF-I and disease-free survival or overall

survival [91].

• One study noted a direct association, though not statistically significant, between non-fasting serum

insulin* levels and 10-year mortality in postmenopausal breast cancer women [102].

• Among other factors, a diet low in fiber may favor the development of insulin* resistance and

hyperinsulinemia [89].

1BMI refers to body mass index, which is calculated by body weight (kg)/height2(m2).

• Hyperinsulinemia may contribute to the development of breast cancer in overweight or obese

women [103].

• Additionally, obesity and fasting hyperinsulinemia have been associated with a poorer prognosis in

women with established breast cancer [104].

• A recent case-control* study reported that carbohydrate intake significantly increased risk of breast

cancer; sucrose (table sugar) imparted the greatest risk [105]. This risk was lessened considerably

with a higher fiber intake.

• Furthermore, an Italian case-control* study found that women who consumed the highest tertile

of desserts and sugars had a 19% increased risk of breast cancer compared with women in the

lowest tertile [106].


• The consumption of sweet foods with a high glycemic index (GI) and glycemic load (GL) have been

implicated as a risk factor for breast cancer due to their effects on insulin and IGF-I [107-110].

o Women who consumed the greatest intake of desserts (including biscuits, brioches, cakes,

puffs and ice-cream) and sugars (including sugar, honey, jam, marmalade and chocolate) had a

19% increased risk of breast cancer compared with women who consumed the least desserts

and sugars [107].

• Adding credence to the idea that blood sugar levels may affect disease progression, women who

consumed a high GI and GL diet had a 57% and 253% increased risk of breast cancer, respectively


o This effect was most pronounced in premenopausal women and those women at a healthy

body weight.

• GI and GL were both associated with an increased risk of breast cancer among postmenopausal

overweight women; this effect was most pronounced for women with ER- breast cancer [109].

• This evidence was further supported by a meta-analysis that reported GI to modestly increase the

risk of breast cancer [110].


INSULIN HIGH TIDE. The observed link between obesity and cancer may be explained by the growthpromoting

activities of insulin and IGF-1. One theory posits that excess weight sets off a biochemical

cascade that increases insulin and, in turn, IGF-1 levels. Both hormones may activate IGF-1 receptors

on cells, which can spur cell growth and inhibit cell death pathways that usually protect against tumor


E. Roell/Source: Nature Reviews Cancer, 2004


Sugars & Insulin* – Bottom Line

• To help control your insulin* level:

o Eat a high-fiber diet with limited refined/processed foods

o Follow a low fat diet rich in omega-3 fatty acids

o Exercise

o Maintain a healthy body weight



Several studies have investigated the relationship of fat and the risk of breast cancer, but the results

remain inconsistent. However, two recent trials showed some promise in the area. The Women’s

Intervention Nutrition Study (WINS) found that a reduced fat intake improves relapse-free survival

by 24% in postmenopausal women with breast cancer compared with women following a standard

diet [111]. The risk of recurrence for women with ER- breast cancer decreased by 42%. Later, the

European Prospective Investigation into Nutrition and Cancer (EPIC) Study reported that eating a

higher fat diet significantly increased the risk of breast cancer; women who had a 35% and 39% fat

diet were at a greater risk than those eating a 31% fat diet [112]. While neither of these diets would

be considered low fat, a significant effect was still observed.


The potential elevated cancer risk may be, in part, due to the fact that a high fat diet stimulates

increased estrogen levels, which is associated with breast cancer growth. A study of adolescent

females found that modest reductions in fat intake during puberty resulted in significantly lower concentrations

of sex hormones (estradiol*, estrone*, progesterone) [113]. Further research is needed to

determine if in fact these lower levels lead to a reduced risk of breast cancer.

Additionally, a low fat, high carbohydrate diet may result in a significant reduction in breast density,

particularly in women going through menopause. Aim for close to 20% of your total calories from

fat, with less than 8% of total calories from saturated fat. Research indicates that the type of fat

may be of paramount importance.

Saturated Fats

• Several studies indicate a positive association between saturated fat intake from meat and

dairy products (animal sources) and cancer [114-117]. The breast cancer research, however, is


• Total saturated fatty acid intake was significantly associated with breast cancer risk in cohort*

studies in postmenopausal women, but not premenopausal women [118].

• Based on a seven-day diary for evaluating saturated fat intake, a high intake of saturated fat was

reported to increase the risk of breast cancer [116].

• A meta-analysis* observed a 19% increased risk of breast cancer with greater intake of saturated

fats [119].

• Other studies, however, have not found a significant association between saturated fats and breast

cancer [120-122].

Trans-Fatty Acids

• Preliminary research indicates that these fatty acids may be associated with an increased risk of

cancer [123-126].

• Minimal research exists on the relationship between trans-fatty acids and risk of breast cancer, thus,

more research is needed for conclusive evidence. However, some evidence points to a positive

association between these fats and breast cancer risk [125,127].

• These fats may disrupt hormonal systems that regulate healing, lead to the destruction of defective

membranes, and encourage the development of cancer.

• One study reported a 40% increased risk of breast cancer in postmenopausal women who had

higher tissue levels of trans-fatty acids [128].

• Women who consumed greater amounts of trans-fatty acids significantly increased their risk of

breast cancer [126].

o Women in the highest quintile of trans-fatty acid consumption had a 75% increased risk

compared with women in the lowest quintile.

Omega-9 Fatty Acids (Monounsaturated Fats)

• Most research at this time indicates a neutral relationship [120,126] or a slightly protective effect

[122,129-131] between these fats and risk of breast cancer.

• Several case-control* studies reported that olive oil consumption, rich in omega-9 fats, resulted in a

13-34% reduction in breast cancer risk [132-135].

o One study found that women who consumed ≥8.8 g/day of olive oil had a 73% lower risk of

breast cancer [131].

• Oleic acid, an omega-9 fatty acid found in olive oil, has been observed to synergistically enhance

the efficacy of trastuzumab (Herceptin) [136,137].

• A meta-analysis*, however, that included three cohort* studies reported total monounsaturated fatty

acids and oleic acid, a type of omega-9 fatty acid, to significantly increase breast cancer risk [118].

Essential Fatty Acids (EFA)

Essential fatty acids are necessary for the formation of healthy cell membranes, the proper

development and functioning of the brain and nervous system, and for the production of hormonelike

substances called eicosanoids* (thromboxanes, leukotrienes, prostaglandins). Among other body

functions, these chemicals regulate immune and inflammatory responses.

Eicosanoids* formed from the omega-6 fatty acids have the potential to increase blood pressure,

inflammation, platelet aggregation, allergic reactions and cell proliferation. Those formed from the

omega-3 fatty acids have opposing affects. Current research suggests that the levels of essential

fatty acids and the balance between them may play a critical role in the prevention and treatment of


Omega-3 Fatty Acids

• Research is growing supporting a protective relationship between omega-3 fatty acids [alpha

linolenic acid (ALA), eicosapentanoic acid (EPA), and docosahexanoic acid (DHA)] against the risk of

breast cancer [118,120,135-141].

• Studies show that omega-3 fatty acids inhibit breast cancer tumor growth and metastasis.

Additionally, these fats are immune enhancing.

• Mechanisms proposed for their protective effects include:

o Suppression of eicosanoid synthesis from arachidonic acid (omega-6 fatty acid), which

impedes immune function [139,142].

o Inhibit cell growth and differentiation via effects on gene expression and signal transduction

pathways [139,142].

o Alter estrogen metabolism, which reduces estrogen-stimulated cell growth [139,142].

o Effects on insulin* sensitivity and membrane fluidity [142].

• A prospective study reported that women who consumed 44 g or more of dietary marine sources of

omega-3 fatty acids reduced their risk of breast cancer by 26% when compared with women who

consumed 25 g or less [120].

• Women with the greatest EPA, DHA, and total omega-3 fatty acids in their red blood cell

membranes from fish had a 73%, 94%, and 89% lower risk of breast cancer, respectively [140].

• An inverse relationship was found between omega-3 fatty acids in breast tissue and the risk of

breast cancer [137].

o When comparing women in the highest tertile of ALA and DHA to the lowest tertile, cancer risk

was reduced by 61% and 69%, respectively.

• Preliminary research indicates that DHA may synergistically enhance taxane cytotoxicity [143]. More

research is needed, but these findings would indicate that DHA during taxane administration may

improve the effects of chemotherapy for breast cancer patients.

• Fish and plant-based foods, however, contain different types of omega-3 fatty acids.

o Fish contains EPA and DHA, two specific fatty acids that have shown promising results in the

research literature [135,140,144].

o Fish consumption in general has been associated with a protective effect against breast cancer


o The plant-based omega-3 fatty acid sources, such as flaxseed and others listed in the table

below, contain ALA. In an ideal environment, ALA is converted to EPA and DHA, however, this

process is inefficient [69,142,146]. On the positive side, the conversion process is enhanced by

following a diet that is low in saturated fats and low in omega-6 fatty acids [142,147].

Omega-6 Fatty Acids

• Recent studies indicate that a high intake of omega-6 fatty acids (linoleic acid, which can

be converted to arachidonic acid) promote breast tumor development and metastasis


• A meta-analysis* of 3 cohort* studies found palmitic acid, a type of omega-6 fatty acid, to be

significantly associated with an increased risk of breast cancer [118].

• Additionally, researchers reported that arachidonic acid, an omega-6 fatty acid almost exclusively

from meat, significantly increased oxidative damage as measured by urinary biomarkers [150].

• It is known that cyclooxygenase is the rate-limiting enzyme that catalyzes the conversion of

arachidonic acid to prostaglandins. Furthermore, COX-2 is known to be overexpressed in various

human cancers. In this breast cancer study, COX-2 overexpression was significantly correlated with

larger tumor size and advanced clinical stage, which indicates a poorer prognosis [149].

• A very interesting finding was reported in a prospective study that found no overall association

between omega-6 fatty acids and risk of breast cancer [120]. However, omega-6 fat consumption

increased risk by 87% in women who consumed 25 g or less of marine omega-3 fatty acids. This

effect was even greater for advanced breast cancer.

o Thus, the balance between omega-6 and omega-3 fatty acids may be of paramount

importance. This was further supported by other studies [137,138,151,152].

Fat – Bottom Line

• Less fat is better.

• Limit animal fats.

• Avoid hydrogenated fats.

• Extra-virgin olive oil, canola oil, macadamia nut oil or almond oil is preferred for salads

and cooking.

• Increase omega-3 fatty acids.

Fatty Acid Dietary Sources Recommendation

Saturated fatty acids Meats, poultry skin, baked goods,

and whole milk dairy products,

including butter, cheese, and ice


Reduce or eliminate meat and

whole milk dairy products.

Trans fatty acids Margarine, fried foods, commercial

peanut butter, salad dressings and

various processed foods including

breads, crackers, cereals, and


Avoid trans or hydrogenated


Products may be labeled “trans

fat free” if they contain less

than 0.5 mg per serving.

Omega-9 fatty acids Extra-virgin olive oil, almond oil,

canola oil, macadamia nut oil,

almonds, and avocados

Include these healthy fats daily.

Limit consumption of nuts to no

more than ¼ cup with meal

or snack to limit total fat and



Omega-3 fatty acids:



Cold-water fish (for example:

salmon, sardines, black cod, trout,

herring), breastmilk, and DHAenriched


Flaxseeds, chia seeds, walnuts,

hempseeds, and pumpkin seeds

Include these healthy fats

daily through diet and/or


It may be wise to consume

cold water fish or fish oil

supplements at least twice

weekly to obtain an adequate

amount of EPA and DHA.

If you choose to use a

supplement, opt for one that

is highest in EPA and DHA


Omega-6 fatty acids:

Arachidonic acid

Linoleic acid

Meats, butter, egg yolks, whole milk,

and whole milk dairy products

Common vegetable oils, such as

corn oil, safflower oil, sunflower

oil, and cottonseed oil, and

processed foods made with these


Reduce or eliminate meat and

whole milk dairy products.

Limit consumption of linoleic

acid-rich oils.

Substitute an omega-9 fatty

acid-rich oil for your current

cooking oil or fat.


• In a study of over 35,000 women, meat consumption significantly increased the risk of breast

cancer in both premenopausal and postmenopausal women [153].

o Women eating 1.75 ounces of processed meat daily increased the risk of breast cancer by

64% in postmenopausal women compared to women who did not eat meat.

• Consumption of red and fried meat quadrupled the risk of breast cancer in a case-control study in

Brazil [12].

• Meat consumption increased the risk of breast cancer risk by 56% for each additional 100 g (3.5

oz) daily of meat consumption in a French case-control study [135].

• Regular consumption of fatty red meat and pork fat increased the risk of breast cancer by 348%

and 632%, respectively in a small Brazilian study [154].

• A large case-control* study found that women who consumed very well-done meat for hamburger,

bacon, and steak had a 54%, 64%, and 221% increased risk for breast cancer, respectively [155].

o Frequent consumers of these well-done meats had a 462% greater risk of breast cancer.


Food Category Summary Recommendation

Fruits and vegetables One serving =

½ cup fruit or vegetable

1 cup raw leafy greens

¼ cup dried fruit or vegetable

6 oz fruit or vegetable juice

Eat 1 cup or more vegetables with

lunch and dinner.

At least 5, preferably 8-10 total

servings daily [156]

5 or more vegetable servings

3 fruit servings

Fiber Choose breads with 3 or more

grams of fiber per slice.

First ingredient on the label should

be whole or sprouted grain flour,

not white flour, unbleached white

flour, or enriched wheat flour.

Whole grains include, among

others, oats, barley, brown rice,

quinoa, amaranth, bulgur, millet,

buckwheat, spelt, wild rice, and


30-45 grams daily

This goal can be achieved

by meeting your fruit and

vegetable goal plus one

serving of legumes or at least

two servings of whole grains.

Refined carbohydrates and


Dietary sources include products

made with refined flours (for

example: white bread, white rice,

white pasta) or refined grains,

alcohol, sodas, drinks containing

added sugars, and desserts, such

as candy, cookies, cakes, and


Limit or avoid consumption.

Meat Dietary sources include beef, pork,

and lamb.

Reduce or eliminate meat


Avoid processed, grilled or fried


GENOTOXINS: Heterocyclic Amines (HCAs) & Polycyclic Aromatic Hydrocarbons (PAHs)

• Natural components in meat, such as amino acids, creatine*, and polysaccharide precursors,

are converted to HCAs during high-temperature cooking. HCAs are known to cause cancer in

laboratory animals [157,158].

• While human research is forthcoming, the majority of studies [155,157-162] although not all

[163,164] have observed a significant association between HCAs and breast cancer.

• Carcinogenic activity of HCA’s is affected by various dietary factors [165]:

o Factors that enhance carcinogenesis* when combined with HCAs include:

• High-fat diet

• Caffeine


o Factors that inhibit carcinogenesis* when combined with HCAs include:


• Conjugated linoleic acid (CLA)

• Isoflavones

• Diallyl Sulfides (found in the allium family, such as garlic, onions, leaks, and shallots)

• Green tea catechins*

• Indole-3 carbinol

• Probiotics

• Gamma-tocopherol

• The most important variables contributing to the formation of HCAs are:

o Cooking temperature (greater than 300°F)

o Cooking time (greater than 2 minutes)

o Cooking method (frying, oven grilling/broiling, barbecuing)

• Charring of food (charcoal-broiled or smoked foods) contribute to PAHs [166].

• Meat can potentially be made “safer” to eat by being cooked in a way that does not lead to HCA


o Choose lean, well-trimmed meats to grill.

o Using marinades significantly reduces the amount of HCAs.

o Brief microwave preheating substantially reduces HCA content of cooked meat.

o Small portions require less time on the grill.

• Additionally, the type of protein cooked can also affect the concentration of HCAs. It has been

reported, for example, that chicken has more than 100 times the number of HCAs than salmon [165].

London broiled steak had more than 600 times the amount of HCAs when compared to salmon.

• Grill vegetables or meat alternatives that do not lead to the formation of HCAs or PAHs.


• Regular consumption of alcohol may increase the risk for breast cancer [167-176].

o A recent review study reported that data from many well-designed studies consistently shows

a small rise in breast cancer risk with increasing consumption of alcohol [172].

• A recent study found that as little as a half a glass of wine a day raised a woman’s risk of

developing breast cancer by 6% (increased risk by 18% in postmenopausal women) [167].

o Furthermore, 1-2 drinks a day increased risk by 21% and 2 or more drinks a day increased risk

by 37%.

o The heightened risk was more pronounced for women with ER+ and progesterone-receptor

positive (PR+) tumor types.

•Women who drank two or more alcoholic drinks daily in the five years prior to diagnosis had an


82% increased risk of breast cancer compared to non drinkers [173].

•A pooled analysis of six prospective studies suggests that the risk of breast cancer increases

linearly by 9% with each 10 g /day (~ 1 drink) alcohol [177]. The risk increased to 41% when

comparing women who consumed 30-60 g/day (~2-5 drinks) to nondrinkers.

•A large meta-analysis* revealed that one drink daily increased breast cancer risk by 11% [178]. A

later meta-analysis* found similar findings [179].

•Since then, another meta-analysis* reported that breast cancer risk increased by 32% and 46% in

women who consumed 35-44 g alcohol (~3-4 drinks) daily and 45 g or more (~4.5 drinks or more)

daily, respectively [170].

o For each additional 10 g of alcohol (~1 drink) daily, risk increased by 7%.

•Other studies [168] claim that one glass of alcohol daily does not increase risk, but consuming 2-5

drinks daily increases the risk of breast cancer by 40% compared to non-drinkers [168].

o Greatest risk was among heavy drinkers who were also postmenopausal and had a history of

benign breast disease or who used hormone replacement therapy (HRT) [168].

•Similarly, a French study found that drinking 10-12 g wine (~ 1-1.5 drinks) daily lowered the risk of

breast cancer, but when intake increased above 12 g daily, the risk of breast cancer increased [180].

•Among ER+ postmenopausal women, those who consumed approximately 3 drinks or more daily

had a 76% increased risk of breast cancer when compared with women who did not consume

alcohol [181].

o The association between alcohol and ER- tumors was less clearly associated.

o Additionally, there was no clear association between alcohol and premenopausal risk of breast


•A recent cohort* study of postmenopausal women reported that alcohol consumption was

associated with an increased risk of breast cancer in ER+, but not ER- tumors [182].

•On a similar note, a recent meta-analysis reported that an increase in 10 g (~1 drink) alcohol daily

increased the risk of breast cancer, especially for women with ER+ breast cancers –ER+ (12%

risk), all ER- (7% risk), ER+PR+ (11% risk) ER+PR- (15% risk), ER-PR- (no effect) [174].

•Petri and colleagues [171] observed a stronger relationship between alcohol and breast cancer in

postmenopausal women compared to premenopausal women.

o Premenopausal women drinking more than 27 drinks per week had a 3.5% higher risk than

women who had one drink per week.

o Postmenopausal women drinking six or more alcoholic beverages per week had a 2.4% higher

risk than women who had one drink per week.

•On the contrary, women who drank about 1.5 drinks per week had a 40% greater likelihood of

developing breast cancer compared to non drinkers and this was most pronounced in women who

were premenopausal at diagnosis [175].

•Alcohol consumption (1 drink/day) during a woman’s fifties increased risk for postmenopausal

breast cancer by 12% in a large cohort* study, but statistical significance was not reached for

women in their twenties, thirties, or forties [169].

•These differing findings between pre- and postmenopausal women are likely related to the effect of

alcohol on estrogen levels. Alcohol appears to increase endogenous* estrogen levels [183-187].

•Folate, a B vitamin, may be of even greater significance with alcohol consumption. It has been

observed that women with low folate and high alcohol consumption had a 43% greater risk of


breast cancer when compared with nondrinkers with adequate folate intake [188].

Alcohol –Bottom Line

•It is best to limit or avoid alcohol.


The functions of water in the body include the following:

o Carries nutrients and waste products.

o Participates in chemical reactions.

o Acts as a lubricant and cushion around joints.

o Acts as a shock absorber in the eyes and spinal cord.

o Aids in the body’ temperature regulation.

o Maintains blood volume.

•Increased fluid intake is needed for a high fiber diet.

•Drink plenty of water daily to help meet fluid needs.


•The risk of breast cancer is much higher in industrial countries than in developing countries where

women are characterized by lower energy intake and higher energy expenditure.

•Modest caloric restriction has been shown to inhibit tumor growth in animal models decrease

oxidative DNA damage [189].

•Modest caloric restriction has been shown to decrease oxidative DNA damage.

•The mechanism involved may be related to the decrease in IGF-I observed when caloric intake is

restricted [190,191].

•Furthermore, evidence suggests that a high calorie diet may increase IGF-I levels [192].


•Epidemiologic evidence suggests a positive association between body mass and postmenopausal

breast cancer [193-196].

o Increasing BMI was associated with a 40% increased incidence and mortality of breast cancer

in postmenopausal women [197].

o Women with a BMI of ≥5 had a 58% increased risk of breast cancer [5].

o Obese postmenopausal women had 3.26-fold increased risk for breast cancer compared to

healthy weight women [198].

o In women with breast cancer, height and BMI were associated with postmenopausal breast

cancer [199].


•This effect was most pronounced in women with ER+ tumors.

o Obese postmenopausal women had a 50% increased risk for breast cancer [196].

•A recent case-control* study of 2000 women found that women who gain weight, particularly after

age 50, significantly increase their risk of breast cancer [200]. Conversely, women (young and

middle-aged) who lose weight may decrease the risk of breast cancer.

o This study suggests excess body fat increases estrogen levels, which may in turn increase the

risk for breast cancer.

o An earlier study reported similar findings with total weight gain serving as a strong predictor of

breast cancer risk, specifically among former and never HRT users [193].

•Increasing BMI was associated with a 40% increased incidence and mortality of breast cancer in

postmenopausal women [197].

•Results from a systematic review showed that, when adjusted for BMI, a larger waist size increased

risk of breast cancer among premenopausal women [202]. This study supports the idea that central

obesity is of greater concern than general obesity in regards to breast cancer risk.

o However, for postmenopausal women, a large trial found that, while general obesity was a

significant predictor of breast cancer risk, central obesity did not appear to be associated with

increased risk [203].

•Total body weight, BMI, and hip circumference were significantly associated with breast cancer risk

among HRT nonusers; obese women (BMI > 30) had a 31% greater risk compared to women with

BMI < 25 [203].

•Overweight or obesity is associated with poorer prognosis in the majority of the studies that have

examined body mass and breast cancer [204-210].

•Various studies report increased BMI or body weight to be a significant risk factor for recurrent

disease, survival, or both [204-210].

o May be related to increased estrogen [196,211,212] and elevated insulin* and IGF, which can

stimulate cell proliferation [101,204].

o Obese postmenopausal women (BMI >30) had 35% higher concentrations of estrone* and

130% higher concentrations of estradiol* compared with lighter-weight women (BMI < 22.0)

[211]. Additionally, free estradiol* and free testosterone were two to three times greater in

overweight and obese women compared with lighter-weight women.

o Recent findings indicated that oxidative damage, measured by urinary biomarkers, was

significantly greater in women with a higher BMI [150].

o Obesity among premenopausal women, however, may not be associated with increased risk

of breast cancer. Nonetheless, obesity during menstruating years is associated with obesity

throughout life and therefore to an eventual increased risk of breast cancer [132]. However,

other research suggests a stronger relationship between body weight and breast cancer in

premenopausal women [208,210].

o A cohort* study of 1300 women reported that breast cancer recurrence and death increased

with body weight in both premenopausal and postmenopausal women [158].

•Body weight prior to breast cancer diagnosis significantly increased risk of recurrence and death in

nonsmokers [208].

o Additionally, nonsmokers who gained weight after diagnosis had an elevated risk of breast cancer

death during follow-up (median, 9 years), compared with women who maintained their weight.


•Women with a BMI of ≥5 had a 58% increased risk of breast cancer [5].

•Research suggests a potential link between obesity, diabetes mellitus and breast cancer [214].

•Eating foods high in vitamin C, such as fruits and vegetables, may provide a protective effect from

breast cancer for overweight women (BMI>25) [215].


•Low levels of physical exercise appear to be associated with the risk of breast cancer [172,195,216-218].

•Lifetime total physical activity has been associated with a decreased risk of breast cancer


o Some studies indicate that physical activity has a more significant effect in reducing risk of

breast cancer in postmenopausal women [222].

o Exercise between the years of 14-20 appears to be the most beneficial in reducing risk of

breast cancer [219].

•A case-control* study reported significantly reduced breast cancer risk among women who

maintained, on average, 17.6 (MET)-hr of activity/week2 from menarche onward [195]. This

decreased risk with physical activity was limited to women without a family history of breast cancer

when adjusted for BMI.

•A cohort* study reported that postmenopausal women who were most physically active (> 42.0

MET-h/week)3 at baseline had a 29% lower incidence of breast cancer than active women with the

least activity (> 0-7.0 MET-h/week) 4 [218]. This difference was greatest for women who did not use

HRT at enrollment.

•Women who engaged in regular strenuous physical activity at age 35 had a 14% reduced risk of

breast cancer compared with less active women [217]. A similar trend was observed for regular

strenuous activity at age 18 and at age 50. These findings were consistent with women who did

and did not use HRT.

•Furthermore, a prospective observational study reported that physical activity after a breast cancer

diagnosis may reduce the risk of death from this disease [216]. The greatest benefit occurred in

women who performed the equivalent of walking 3 to 5 hours per week at an average pace. The

benefit of physical activity was particularly apparent among women with hormone-responsive


•As noted earlier, the combination of consuming five or more daily servings of vegetables and fruits,

and accumulating 540+ metabolic equivalent tasks-min/wk (equivalent to walking 30 minutes

6 d/wk) decreased mortality by nearly 50% [11].

o The effect was stronger in women who had ER+ cancers.

•Increased physical activity following breast cancer diagnosis significantly decreased the risk of

dying from breast cancer and improved overall survival when compared with women who exercised

<2.8 MET-h/wk [224].

•Survival may be enhanced by physical activity in those women who exercised the year prior to

diagnosis, especially women who were overweight or obese [225].

•Exercise was associated with improved quality of life among survivors [226,227].


•Physical activity can help ease cancer-related fatigue during and following cancer treatment


•Physical activity may reduce the risk of breast cancer through an influence on ovarian function and

a decrease in progesterone and estrogen concentrations via reduced body fat [217]. Furthermore,

exercise may increase sex hormone-binding globulin* (SHBG) levels and thereby reduce estradiol*.

•An increase in lean body mass (often achieved through physical activity) was associated with

a favorable change in 2-hydroxyestrone: 16-α-hydroxyestrone, a proposed biomarker of breast

cancer risk [230].

•Additionally, exercise reduces serum insulin levels [231], serum IGF-I levels [217,232], and improves

insulin* sensitivity [217].

•Greater physical activity in obese women was associated with significantly less mammographic

density, possibly suggesting another mechanism for the protective effect of physical activity [233].

•Healthy weight control is encouraged with an emphasis on exercise to preserve or increase lean

muscle mass.

2 This is equivalent to a 150lb individual burning 1257 kcals/week through physical activity.

3 This is equivalent to a 150lb individual burning about 3000 kcals/week through physical activity.

4 This is equivalent to a 150lb individual burning 500 kcals/week or less through physical activity.

Additional Nutritional and Lifestyle Factors for Breast Cancer Survivors

ANTIOXIDANTS* –Found in abundance in fruits and vegetables!

•Prevent oxidative damage in body cells.

o Research indicates a link between oxidant damage and breast carcinogenesis*.

•Examples of antioxidant* nutrients and non-nutrients include vitamins A, C, and E, selenium,

lycopene, and beta-carotene.

•Note that patients may be advised to NOT consume high-dose antioxidant* supplements during

chemotherapy or radiation therapy. Antioxidant* consumption via food sources and a basic

multivitamin supplement are very safe.


•Antioxidant* that scavenges free radicals and suppresses damage due to oxidation. Also is

essential for the immune system.

•Promising evidence indicates that selenium may decrease the risk of breast cancer [234-239].

o Inhibits cell proliferation and induces apoptosis* [238,239].

•Selenium may interfere and alter estrogen receptors decreasing mammary tumor incidence [236].

• Research shows that selenium reduces the incidence of malignant cells in animal models [237], and

enhances the effects of chemotherapeutic drugs, such as [235] taxol and adriamycin [235,239].

• Toenail selenium concentrations tended to be lower in postmenopausal breast cancer patients when

compared with healthy non-cancer patients, but the differences did not reach statistical significance [240].

o Interestingly, this study also found that plasma triiodothyronine (T3) (a thyroid hormone)

concentration was positively associated with toenail selenium in breast cancer patients and

controls. T3 concentration was significantly lower in breast cancer patients compared to

healthy non-cancer patients.

• A recent study suggested the combination of selenium and iodine, typical of a Japanese diet, act

synergistically in decreasing breast cancer risk [241]. It is known that iodine plays an important role in

thyroid function. Thus, selenium status may affect both thyroid hormone status and iodine availability.

• Selenium is a precursor to the glutathione* (GSH) antioxidant* system. GSH is the principal

protective mechanism of the cell and is a crucial factor in the development of the immune response

by the immune cells [242].

o Studies suggest the ratio of selenium to glutathione* is at lower levels in breast cancer patients

[234]. Research indicates that dietary selenium supplements correct abnormal glutathione*


Turmeric (Curcumin)

• Curcumin, the yellow pigment and active component of turmeric and many curries, is a potent

antioxidant*, that exhibits chemopreventive and growth inhibitory activity in several tumor cell lines


• Evidence suggests that curcumin may suppress tumor initiation, promotion and metastasis [245,247].

o This may occur through enhanced apoptosis* [243,245].

• Additionally, curcumin promotes detoxification in the liver and possesses anti-inflammatory activity,

possibly by inhibiting COX-2 activity [248,249].

Vitamin C

• Most research [250-255], although not all [7,19,256,257], has shown no protective relationship

between vitamin C and the risk of breast cancer.

o Vitamin C induces apoptotic effects on breast cancer cells [257].

• Low plasma levels of vitamin C have been associated with a greater risk of breast cancer [258].

• Dietary vitamin C has been significantly associated with reduced mortality in breast cancer

survivors [19].

• Furthermore, risk of recurrence and mortality was reduced in women who consumed vitamin C

supplements for more than three years [259].

Vitamin E

• Vitamin E acts as a cellular antioxidant* and an anti-proliferating agent. It consists of both

tocopherols and tocotrienols.


o Some research indicates that tocotrienols are the components of vitamin E responsible for

growth inhibition in human breast cancer cells [260].

• Research is inconsistent on the protective effects of vitamin E and breast cancer. Data from most

prospective studies have not revealed a protective relationship between vitamin E and risk of breast

cancer [250].

• Supplemental vitamin E does not consistently appear to offer protection against breast cancer [150]

although taking vitamin E for more than three years has been associated with a modest protective

effect [259]. Additionally, these researchers reported a decreased risk of recurrence and mortality

associated with long-term use of vitamin E supplements.

• However, low plasma levels of vitamin E have been associated with a greater risk of breast cancer [258].

• It was demonstrated recently that dietary vitamin E, unlike supplemental sources of vitamin E,

significantly reduced oxidative damage as measured by urinary biomarkers [150].

• Note that findings suggest that vitamin E supplements may interfere with the therapeutic effects of

tamoxifen [261].


• Resveratrol is a polyphenol found primarily in red grape skins with known antioxidant and antiinflammatory

properties, and is emerging as a potent chemopreventive and anticancer drug [262].

• Resveratrol has exhibited potential anticarcinogenic activities in several studies.

o Reduced tumor growth, decreased angiogenesis, and induced apoptosis in mice [263].

o Less tumors and longer tumor latency in a rat study [264].

o May inhibit IGF-I mediated cell migration in breast cancer cells [265].

o Induces apoptosis in breast cancer cells [262,263].

o Decreased levels of vascular endothelial growth factor (VEGF) in breast cancer cells [263].

o Inhibited cell growth and regulates IGF-II in breast cancer cells [266].

• Recent evidence indicates that resveratrol and glucans have significant synergistic effects on

immune function [267].

Nutrient/Phytonutrient Summary Recommendation

Selenium Dietary sources include Brazil nuts,

seafood, enriched brewer’s yeast,

and grains.

Selenium content depends

somewhat on the amount of

selenium in the soil in which the

products are grown.

200 mcg selenium daily through

diet and/or supplements

Two Brazil nuts provide 200

mcg selenium.

Turmeric (curcumin) A deep orange-yellow spice

commonly used in curries and

Indian cuisine.

Eat liberally.


Vitamin C Dietary sources include various fruits

and vegetables, including papaya,

citrus fruits, kiwi, cantaloupe,

mango, strawberries, bell peppers,

broccoli, and tomatoes.

Include these fruits and

vegetables daily.

Vitamin E Dietary sources include vegetable

oils, wheat germ, sweet potatoes,

nuts, seeds, and avocados.

Eat vitamin E-rich foods


More research is needed to

assess whether or not

supplements would be


Resveratrol Dietary sources include grapes,

grape products, peanuts, soy,

mulberries, and cranberries.

Eat resveratrol-rich foods


More research is needed

to assess whether or not

supplements would be



• Flax may also work to block tumor growth, inhibit angiogenesis*, and enhance the immune system [268].

• Consumption of 5 or 10 g flax for 7 weeks significantly decreased blood levels of estrone* and

estradiol* [269].

• Flax has been shown to enhance the effects of tamoxifen [270].

• Flaxseed is the greatest source of mammalian lignans* [271,272], phytoestrogens found in flax,

which appear to bind with estrogen and lower circulating levels of estrogen. This action may act as

one of the protective mechanisms of flax for breast cancer.

o Lignans* facilitate the removal of estrogens via increased retention within the gut, which are

later eliminated in the feces [273,274].

• Furthermore, lignans* positively influence estrogen metabolism by improving the ratio of 2:16a

hydroxyestrone [273,274].

• A recent study indicates that flaxseed (25 g daily) and its metabolites, such as lignans*, reduced

tumor growth in patients with breast cancer [271].

• Additionally, a recent pilot study observed lower breast density with a greater intake of dietary

lignans* [275]. Dense breasts are a risk factor for breast cancer.

• Flax has been shown in vitro and in human trials to decrease tumor proliferation of breast cancer

cells [271].

• An animal study reported that flaxseed inhibited established human breast cancer growth and

reduced incidence of metastasis by 45% [272].

• Tumor growth was reduced by 26% and 38%, respectively, when mice consumed a 5% flaxseed

diet and 10% flaxseed diet compared with those who ate no flaxseed [270].

o This effect may be partially due to its downregulation of IGF-I [270,272,276], decreased cell

proliferation [270], and increased apoptosis [270].



• Tea contains phytonutrients* known as polyphenols* (flavonoids) that provide antioxidant* and

anticancer properties [277].

o May block the formation of cancer-causing nitrosamines* [278].

o Prevents DNA damage [279].

o May inhibit tumor growth and induce apoptosis* [280-282].

o Increase immune response [281].

o Epigallocatechin gallate (EGCG) alters gene expresssion to lower the risk of breast cancer


• There is a significant amount of in vitro and in vivo evidence suggesting tea polyphenols* have

chemopreventive agents against various cancers [280,284,285]. More human data is needed.

o Green tea and its catechin* components inhibit breast cancer growth and angiogenesis* in both

in vitro and in vivo studies.

o Studies suggest green tea extract has been successful inhibiting cell proliferation and breast

cancer [277].

• Many studies indicate a lower risk of breast cancer with green tea consumption, but more research

is needed for conclusive evidence [286-289].

• EGCG has been shown in human studies to inhibit human breast cancer cell proliferation, reduce

tumor invasion and metastasis and prevent recurrence of breast cancer in early stage cases (stage I

& II) [290-292].

• A meta-analysis* reported that drinking green tea decreased the risk of breast cancer by 22% when

comparing women with the highest vs lowest intake [286].

• A case-control study* found that green tea consumption was associated with a significant reduction

in risk of breast cancer [289].

o Risk by 13% for women consuming 1-249 g of dried green tea leaves annually.

o Risk by 32% for women consuming 250-499 g of dried green tea leaves annually.

o Risk by 41% for women consuming 500-749 g of dried green tea leaves annually.

o Risk by 39% for women consuming ≥750 g of dried green tea leaves annually.

o Moreover, protection was greater with a longer duration of drinking green tea, a greater number

of cups consumed and the more new batches prepared daily.

• However, combined studies of 35000 Japanese women found that green tea did not affect risk of

breast cancer [293].

• Research suggests that while green tea did significantly decrease tumor mass, when green tea was

combined with soy phytonutrients*, the tumor mass decreased even further [294]. Further evidence

indicates a possible synergistic relationship between soy and green tea consumption [288].

• Similarly, a synergistic effect of green tea and Ganoderma lucidum extracts on the suppression of

growth and invasiveness of metastatic breast cancers was observed [295].

• Additionally, green tea increased the inhibitory effect of tamoxifen on the proliferation of ER + breast

cancer cells [296].

• Furthermore, some evidence suggests that the association of tea catechins* and breast cancer may

depend on specific genotypes [284].



• Associated with reduced rates of heart disease [297-299], protection against osteoporosis

[300,301], and certain types of cancer, including breast cancer [302,303].

• While there has been contention regarding soy and breast cancer, research findings are

predominantly neutral [304], if not protective [6,305,306].

o The majority of short-term soy intervention studies conducted in premenopausal women show

a reduction in endogenous* estrogen levels in association with soy intake, and thus, possibly

protecting from breast cancer.

o The conflicting data on the effects of soy isoflavones and breast tumor growth are based on in

vitro (test tube) studies.

• Recent human research has been more promising.

o A statistically significant inverse association between plasma genistein and breast cancer was

reported among Japanese women [305].

o A recent meta-analysis of well-controlled studies that included high-soy-consuming Asians

reported a significant trend of decreasing risk with increasing soy food intake. Risk was lowest

among those who consumed ≥20 mg isoflavones daily [306].

o High soybean intake in Korean women resulted in a significantly lower risk of breast cancer in

postmenopausal women [6].

• It’s becoming more apparent that the timing of soy exposure is critical. Consumption of soy foods

or an exposure to a soy isoflavone genistein during childhood and adolescence in women, and

before puberty onset in animals, appears to reduce the risk of breast cancer later in life [307].

• The type of soy consumed may provide some insight to the inconsistent findings. It has been

demonstrated that soy processing increases tumor growth in mice for postmenopausal ER+ breast

cancer [308].

o The difference in tumor growth observed may be related to isoflavone metabolism and

bioavailability, but more research is needed [309].

o Nonetheless, these studies suggest that WHOLE SOY FOODS appear to not have a

negative effect on postmenopausal ER+ breast cancer.

o A recent cohort* study of breast cancer patients found that soy foods had no negative impact

on breast cancer survival [310,311].

• An Asian-American study on soy found that women, pre- and postmenopausal, who consumed

tofu, had a 15% reduced risk of breast cancer with each additional serving per week [302].

• Moreover, a recent trial reported that women in the highest tertile intake of tofu had a 51% decrease

risk of premenopausal breast cancer when compared with women in the lowest tertile [303]. No

statistical significant association was observed between soy intake and breast cancer risk among

postmenopausal women.

• Soy consumption has been suggested to exert potential cancer-preventive effects in

premenopausal women, such as increased menstrual cycle length and SHBG* levels and reduced

estrogen levels.

o 40 mg/day soy isoflavones increased menstrual cycle length in Western women [312].

o Research also suggests that soy isoflavones may significantly improve the

2-hydroxyestrone:16-a-hydroxyestrone ratio [313].


o Additionally, soy intake increases time spent in the follicular cycles, when proliferation is at its

lowest [312].

• Furthermore, vegan protein sources, such as soy, appear to decrease circulating IGF-I activity,

which may impede cancer induction [298,314,315].

• Recent literature assessing the effects of soy and tamoxifen have yielded neutral [316] or beneficial

findings [317].

o In a study of Asian American breast cancer survivors on tamoxifen, soy intake had no effect on

levels of tamoxifen or its metabolites [316].

o The combination of tamoxifen and genistein inhibited the growth of ER+/HER2- human breast

cancer cells in a synergistic manner in vitro [317].

Source Amount of Soy

Protein (gm)

Amount of Soy

Isoflavones (mg)

Miso (1 tbsp) 2 7-10*

Soybeans, edamame (1/2 cup) 11 35*

Soymilk (8 fl oz) 10 23*

Soy nuts (1/4 cup) 19 40-50*

Tempeh (1/2 cup) 19.5 36*

Tofu (4 oz) 13 39*

* Isoflavone content varies by brand

Vitamin D

• Epidemiological studies suggest an inverse relationship between sun exposure, serum levels of

25(OH)-vitamin D, and vitamin D intake and the risk of developing and/or surviving cancer [318].

o Possible mechanisms that may explain the protective effects of vitamin D may be its role as

a nuclear transcription factor that regulates cell growth, differentiation, apoptosis and a wide

range of cellular mechanisms central to the development of cancer.

o Furthermore, breast density, a factor that may increase the risk of breast cancer, was inversely

associated with vitamin D intake [319].

• The women in the Nurses’ Health Study observed a 30% reduction in risk of breast cancer

comparing the highest with lowest quintiles of 25(OH)-vitamin D levels. [320].

•Post-menopausal breast cancer risk was significantly inversely associated with serum 25(OH)-

vitamin D levels [321].

o Risk decreased as women’s levels increased from 30 nM (12 ng/ml) to ≥75 nM (30 ng/ml).

•It is now believed that the recommended vitamin D dose should be between 800 and 2,000 IU per


o Research indicates that vitamin D3 (cholecaciferol) is better absorbed than vitamin D2

(ergocalciferol) [322].


Due to the likelihood of a biochemical deficiency without clinical symptoms or signs, a serum

25(OH)-vitamin D level is recommended.

o Optimal serum 25-hydroxy vitamin D levels have not been established though research

suggests 36-40 ng/ml may be ideal [323]. Some believe the normal level of vitamin D should be

50-60 ng/ml.

o While supplementation may be recommended, more appropriate dosing of vitamin D

supplementation can be made once a serum 25(OH)-vitamin D level has been established.

Food or Beverage Summary Recommendation

Flaxseed Good source of omega-3 fatty

acids and fiber, contains protein,

calcium, potassium, B vitamins,

iron, and boron.

Opt for ground flax seeds rather

than whole flax seeds, flax seed

oil, flax supplements to increase


Flax seeds may be ground in a

coffee grinder, blender, or food


2 Tbsp ground flaxseed daily

Flax can have a laxativelike

effect, thus, it is wise

to gradually increase


Sprinkle into various foods

and beverages, including

hot cereals, tomato sauces,

fruit smoothies, brown rice or

other grains.

Store flax in the refrigerator or


Green tea Green tea contains does contain

caffeine though much less than

coffee or black tea.

If opting for decaffeinated green

tea, opt for those naturally

decaffeinated with water as typical

caffeine extraction results in a

significant loss of phytonutrients.

1-4 cups daily

Soy Contains various nutrients, including

protein, fiber, calcium, and B


Rich in antioxidants*, known as

isoflavones, namely genistein and


Among others, dietary sources

include soybeans, edamame, tofu,

soymilk, tempeh, miso, and soy


Unless soy has been a part

of your diet for years,

postmenopausal individuals

with ER+ breast cancer

may be advised to limit soy

consumption to 1-3 daily


Soy supplements or

isoflavone extracts are not


Vitamin D A fat-soluble vitamin that we generate

through skin synthesis of sunlight

(ultraviolet rays).

Dietary sources include cold-water

fish, eggs, and fortified products,

such as milk, soy milk, and cereals.

400-2000 IU daily

Maintain serum 25 (OH)-vitamin

D >35 ng/mL.



• Melatonin is a hormone produced by the pineal gland. Its primary function involves the regulation of

the body’s circadian rhythm, endocrine secretions, and sleep patterns.

• Some research indicates that individuals with low levels of melatonin are at greater risk for breast


• The risk of breast cancer was reduced by 33% in postmenopausal women who slept 9+ hours

compared to those who slept ≤6 hours daily [324].

o Melatonin levels were 42% higher in those who slept 9+ hours vs ≤6 hours daily.

o Previous studies have reported an increased risk of breast cancer in night-shift workers who

are exposed to light at night [325-327].

• It may be that the length of time working night shifts makes a difference as

evidenced by this study where women who reported more than 20 years of rotating

night shift work faced an increased risk of breast cancer compared with women who

did not report any rotating night shift work [326].

o In vitro and animal research has supported the protective effect of melatonin against breast

cancer [328].

o A recent study found that women with higher urinary melatonin levels had a 30-41% reduced

risk of breast cancer [329].

• Melatonin may act by:

o Inhibiting cell proliferation [330,331].

o Inducing apoptosis* [332].

o Enhancing the immune system [330,333].

• May improve survival in cancer patients by protecting the immune system from

damage caused by chemotherapy [332].

o Reducing IGF-I [334,335].

o Decreasing the number and activity of estrogen receptors, thus reducing ways that the cancer

cell connects to estrogen [336].

• Various studies indicate that melatonin may inhibit breast cancer by interfering with estrogen

pathways, thus acting in an anti-estrogenic manner [331,333,337,338].

o Melatonin decreases the formation of estrogen from androgens by inhibiting aromatase activity


• Furthermore, the combination of melatonin and retinoids* [339] as well as the combination of melatonin

and vitamin D3 [340] appear to work synergistically to inhibit the growth of breast cancer cells.

• Melatonin does have blood thinning properties, thus it is recommended to not use supplemental

melatonin 7-10 days prior to surgery.


• Especially important for those with weakened or impaired immune systems and while on



• The following recommendations have been adapted from guidelines provided by the American

Cancer Society.

o Wash foods thoroughly before eating.

o Keep all aspects of food preparation meticulously clean.

o Use special care in handling raw meats, poultry, and eggs.

• Thoroughly clean all utensils, countertops, cutting boards, and sponges that

contacted raw meat.

• Thaw meats and fish in the refrigerator.

o Transfer large volumes of leftovers, such as soup, rice, or casseroles, to shallow containers and

place in refrigerator. This process ensures proper cooling.

o Do not eat perishable foods that have been left out of the refrigerator for more than two hours.

o Store foods at low temperatures (less than 40oF) to minimize bacterial growth.

o When eating in restaurants, avoid foods that may have bacterial contamination, including sushi,

salad bars, buffets, unpasteurized beverages or food products, and raw or undercooked meat,

poultry, fish, and eggs.


• Eat 8 to 10 colorful fruit and vegetable servings daily

o Two to three pieces of fruit

o One cup or more of vegetables with lunch and dinner

o 8 fl oz vegetable juice

• Consume 30 to 45 grams of fiber daily

o You will likely meet your fiber goal if you eat 8 to 10 servings of fruits and vegetables plus one

serving of beans/legumes or at least two servings of whole grains daily.

• Avoid processed and refined grains/flours/sugars

o Keep WHITE off your plate: bread, pasta, rice, cream sauces, cakes, and more.

• Limit meats and whole milk dairy products

• Include healthy fats like cold-water fish, flaxseed, walnuts, soybeans, olive oil, avocados

• Eat 2 Tbsp ground flax daily

• Limit alcohol consumption

• Drink 1 to 4 cups of green tea daily

• Maintain serum 25 (OH)-vitamin D levels above 35 ng/mL

• Drink plenty of fluids, water or non-caffeinated beverages, daily to help meet fluid needs

• Engage in daily physical activity to help achieve and maintain a healthy weight


Bone Health

• Pre- and postmenopausal survivors of breast cancer are at great risk for development of


o Thus, screening and preventive strategies for osteoporosis are imperative.

• Even small amounts of increased bone mass provide great risk reduction for fractures.

• Generally, humans reach peak bone mass around 30 years. After the age of 30, the goal is to

maintain or prevent loss of bone mass.

o On average, humans lose 0.3 – 0.5% bone mass yearly after 30 years.

• First signs of osteoporosis are seen in spine, hip, and wrist.

o Symptoms include back pain or tenderness, loss of height, and slight curving of upper back.

• Risks for osteoporosis include: female, Asian or white ethnicity, age, menopause, amenorrhea, low

testosterone levels in men, sedentary lifestyle, family history, diet low in calcium, diet low in vitamin

D, excessive alcohol and tobacco use, excessive caffeine use, diet high in sodium, diet excessive in

protein or very low in protein, certain medications (diuretics, steroids, thyroid meds), celiac disease

• Many nutrients have bone-building effects, including calcium, vitamin D, phosphorus, magnesium,

vitamin K, potassium, and boron (see table below).

• Exercise increases bone mass before menopause and slows bone loss after menopause.

o Include weight-bearing exercise, such as walking, jogging, skiing, stair climbing, aerobics, and


o Resistance training exercises are useful to strengthen muscles and bones.

• Recent research indicates diets high in fruits and vegetables have a positive effect on bone health.

o Good source of minerals (potassium, magnesium) that may have direct effects on bone cells.

o Counteract acid environment.

o Lower urinary calcium loss.

o Enhanced calcium bioavailability of most vegetables.

• Soy protein and/or soy isoflavones have been proposed to delay bone loss.

o May help to prevent urinary calcium loss.

o Soy contains phytosterols that mimic the actions of estrogen.

o May help to prevent rapid bone loss of menopause years.

o Studies report that soy may BMD.

• Calcium supplements

o Take 500 mg or less per meal to maximize absorption.

o Calcium citrate, lactate, or gluconate are recommended if you have iron deficiency.

• These do not decrease iron absorption like calcium carbonate.

o Calcium carbonate is least expensive, but may increase gas and bloating in some individuals.


• What about antacids with calcium?

o Trace minerals like zinc or iron may be less well-dissolved and absorbed with a lower stomach


o If you’re only taking enough antacid for the purpose of calcium needs, should not present a

major problem, but not ideal.

o May interact with thyroid medication.

• DEXA (dual-energy X-ray absorptiometry) instruments allow rapid, painless, noninvasive, and highly

reproducible measurements of bone density to be made [341].

o These measurements are used to diagnose osteoporosis, low bone density, and risk of fracture

and to determine rates of bone loss or the effectiveness of treatment over time [342,343].

Bone Health – Bottom Line

• Balanced diet – high in fruits and vegetables

• Calcium

o Aim for 3 rich sources daily.

o Include a supplement if necessary.

• Vitamin D

o Meet needs from sun, multivitamin, or other supplement.

o Consider serum vitamin D test.

• Exercise

o Weight-bearing exercise for at least 30 minutes on most days.

• Good posture

• Request to have a full body DEXA scan.


Bone Building Nutrients

Nutrient* Dietary Sources Function Recommendation

Calcium Dairy products, canned

fish with soft bones,

beans, leafy greens

(especially collard

greens, bok choy, and

kale), tofu, almonds,

fortified products, such

as soy milk, cereal, and

orange juice

calcium absorption

and bioavailability from

foods, especially plant


Vitamin D is essential for

calcium absorption.

1000-1200 mg


Vitamin K Dark leafy greens, liver,

tomatoes, soybeans,

and garbanzo beans

Also produced by

intestinal bacteria

Associated with bone

turnover and urinary

calcium excretion.

90 mcg daily

Phosphorus Meat, poultry, fish, eggs,

milk, products, legumes,

and nuts

Combines with calcium to

strengthen bones.

700 mg daily

Magnesium Whole grains, nuts, seeds,

spinach, and most fruits

and vegetables

Important in calcium and

potassium uptake.

320 mg daily

Potassium Bananas, strawberries,

tomatoes, prunes,

potatoes, spinach, and


Associated with

urinary calcium and

phosphorus excretion.

4700 mg daily

Boron Apples, avocados, beans,

milk, peanuts, peanut

butter, pecans, raisins,

prunes, and potatoes

Improves calcium


effects of vitamin D and

magnesium deficiency.

2 mg daily

Zinc Seafood, meats, tofu,

whole grains, blackeyed

peas, wheat bran

and germ

Important in calcium

uptake and immune


8-15 mg daily

* Vitamin D is listed in the previous table


Hot Flashes

• Hot flashes are a major cause of morbidity among postmenopausal women, including many

survivors of breast cancer.

• Approximately 75% of postmenopausal women who had breast cancer report experiencing hot

flashes [344].

o More than 90% of young survivors also experience hot flashes, which can be more severe and

long lasting, with iatrogenic ovarian ablation or antiestrogen therapy.

• Various non-hormonal therapies have been studied for improving hot flashes, including soy, black

cohosh, red clover, and vitamin E – none have shown much significant clinical value.

• Supplemental vitamin E at 400 IU/day [345] and 800 IU/day [346] has shown some limited efficacy

in improving hot flashes.

• Systematic reviews of randomized controlled trials have observed contradictory results, and

meta-analyses* demonstrate no statistically significant reduction of vasomotor symptoms for

phytoestrogens [347].

o Individual trials report significant reductions in vasomotor symptoms for red clover and soy


o The placebo effect in many of these studies was quite strong [348].

o Studies assessing black cohosh and red clover have had inconsistent results, with some trials

showing benefit and some no difference compared with placebo [349].

o In one study, women receiving black cohosh reported a mean decrease in hot flash score of

20% compared with a 27% decrease for patients on placebo [350].

• Mean hot flash frequency was reduced 17% on black cohosh and 26% on placebo.

o A previous study reported reduced hot flashes with soy isoflavones by 9 to 40% in some trials,

but most trials observed no effect when compared with placebo [349].

• Black cohosh extract had no effect on serum estrogenic markers [351].

• The use of black cohosh appears to be safe in breast cancer patients [352].

• Psychoeducational interventions, including relaxation, seem to alleviate hot flashes in menopausal

women and breast cancer survivors; however, the methodological quality of published research has

been considered to be fair or poor [353].


“Let food be your medicine and medicine be your food.”

– Hippocrates

For additional information or resources, please visit the Ida and Joseph Friend Cancer Resource

Center at 1600 Divisadero St. on the first floor, or call at (415) 885-3693. The information in this

publication is designed for educational purposes only and is not intended to replace the advice of

your physician or health care provider, as each patient’s circumstances are individual. We encourage

you to discuss with your physician any questions and concerns that you may have.


Three Day Menu Plan: 3 Meals + Snack

This menu is based on 1600 calories, calories can be adjusted by altering portion sizes. The menu

has been designed to merely serve as a guide in making healthy food choices. Experiment with

substitutions as desired.

Day 1 Day 2 Day 3

Oatmeal, cooked (1 cup)

Soy milk (1 cup)

Flaxseed, ground (2 tbsp)

Blueberries (1/2 cup)

Green tea (2 cups)

Bagel, whole grain (1 med)

Hummus (2 tbsp)

Tomato (6 slices)

Lemon pepper

Cantaloupe (1 cup)

Green tea (2 cups)

Tofu scramble

Tofu (4 oz)

Onions (1/4 cup)

Peppers (1/2 cup)

Mushrooms (1/2 cup)

Toast, whole grain (1 slice)

Jam (1 tbsp)

Turkey sandwich

Whole grain bread (2 slices)

Turkey (2 oz)

Lettuce (1/2 cup)

Tomato (4 slices)

Red peppers (1/4 cup)

Onions (2 tbsp)

Mustard (1 tsp)

Carrots (1/2 cup)

Snap peas (1/2 cup)

Vegetable Bean Soup (2 cups)

Corn tortilla (1 med)

Green salad (2 cups)

Oil/vinegar dressing (1 tbsp)


Spinach (3 cups)

Broccoli (1/2 cup)

Carrots (1/2 cup)

Tomato (1/2 cup)

Garbanzo beans (1 cup)

Barley, cooked (1/2 cup)

Avocado (4 slices)

Olive oil (1/2 tbsp)

Vinegar, balsamic (1 1/2 tbsp)

Roll, whole grain (1 med)

Orange (1 med)

Vegetable juice (12 oz)

Granola bar (1 each)

Fruit smoothie

Banana (1 med)

Berries (1 cup)

Flaxseed, ground (2 tbsp)

Yogurt, plain nonfat (1/2 cup)

Soy milk (1 cup)

Green tea (2 cups)

Popcorn, air-popped (3 cups)

Fish (3 oz)

Pasta, whole grain (1 1/2 cups)

Tomato sauce (1 cup)

Mushrooms (1/2 cup)

Olive oil (1/2 tbsp)

Broccoli (1 cup)

Mixed fruit (1 cup)

Chicken & vegetable stir-fry

Chicken breast (4 oz)

Mixed vegetables (2 cups)

Walnuts (2 tbsp) OR

Olive oil (1/2 tbsp)

Brown rice, cooked (1 cup)

Salmon (4 oz)

Quinoa, cooked (1 cup)

Asparagus (1 cup)

Fruit salad (1 cup)



Baked Tofu


• 1 pound tofu, firm, drained

• 3-4 tbsp marinade or sauce (personal favorite: Veri Veri Teriyaki by Soy Vay)

Chop drained firm tofu into 1” cubes. Place tofu cubes in glass dish for baking. Pour marinade or

sauce over tofu, stir well. Place tofu in oven at 350 F for 1 hour. Stir every 15-20 minutes.

Makes four 4-ounce servings.

Nutrition Information (per 4 oz serving):

Calories: 96 Dietary fiber: <1 gm

Protein: 8 gm Sodium: 318 mg

Fat: 5 gm Calcium: 155 mg

Saturated fat: <1 gm Iron: 1.4 mg

Recipe developed by Natalie Ledesma, MS, RD, CSO

Washington Insider Salad


• 1 can (15 oz) kidney beans, drained

• 1 can (15 oz) black eyed peas, drained

• 1 1/2 cups cooked barley

• 6 tbsp cilantro, chopped finely

• 1 can (11 oz) corn

• 1 1/2 cups tomatoes, diced

• 3 tbsp balsamic vinegar

• 2 tbsp olive oil

Prepare vegetables. Mix all ingredients together, and serve on a bed of dark green leafy lettuce. Add

salt and pepper to taste.

Makes 8 servings (1 cup each).

Nutrition Information (per serving):

Calories: 215

Protein: 10 gm

Fat: 4 gm

Dietary fiber: 9 gm

Recipe developed by Sous Chef Chris at the Occidental Grill, Washington D.C.

Spinach Spread


• 1 package (10.5 ounces) silken tofu

• 1 tbsp lemon juice


• 1/4 tsp garlic powder

• 3/4 tsp onion powder

• 1/2 tsp dried tarragon

• 1/4 tsp salt

• 1 box (10 ounce) frozen chopped spinach, thawed

• 1 cup coarsely shredded carrots

• 1/4 cup chopped green onion

Puree the tofu and lemon juice in blender until smooth. Whirl in the garlic and onion powders,

tarragon, and salt just to blend. Scrape into a mixing bowl. Squeeze the spinach as dry as possible.

Stir it into the tofu, along with the carrots and green onion. Mix well. Serve with crackers, pita

triangles, or vegetables.

Makes 8 servings (1/4 cup each).

Nutrition information (per serving):

Calories: 39 Sodium: 82 mg

Fat: 1 gm Calcium: 51 mg

Saturated fat: 0 gm Carbohydrate: 5 gm

Protein: 4 gm Dietary Fiber: 2 gm

Recipe from the U.S. Soyfoods Directory, 1998.

Tofuntastico – Tofu Sauce


• 1 package (12.3 ounce) silken tofu

• 1/2 cup water

• 3/4 cup fresh basil, chopped

• 4 tbsp nutritional yeast

• 3 tbsp Bragg’s liquid aminos (or tamari or soy sauce)

•1 tbsp lemon juice

•1 tsp garlic, minced

•3/4 tsp black pepper

•Alternative: Use lime/cilantro rather than lemon/basil

Blend all ingredients together in a blender or food processor. Serve over pasta, vegetables, baked

potato, or other.

Makes 6 servings (1/2 cup each).

Nutrition Information (per serving):

Calories: 47 Carbohydrate: 4 gm

Protein: 7 gm Dietary fiber: 2 gm

Fat: <1 gm

Recipe developed by Natalie Ledesma, MS, RD, CSO


Alaska Salmon Bake with Walnut Crunch Coating


• 1 pound salmon fillets, thawed if necessary

• 2 tbsp Dijon-style mustard

• 1-2 tbsp olive oil

• 4 tsp honey

• 1/4 cup bread crumbs

• 1/4 cup walnuts, finely chopped

• 2 tsp parsley, chopped

• Salt and pepper to taste

• Lemon wedges

Mix together mustard, olive oil, and honey in a small bowl; set aside. Mix together bread crumbs,

walnuts, and parsley in a small bowl; set aside. Season each salmon fillet with salt and pepper. Place

on a lightly greased baking sheet or broiling pan. Brush each fillet with mustard-honey mixture. Pat

top of each fillet with bread crumb mixture. Bake at 450 F for 10 minutes per inch of thickness or until

salmon just flakes when tested with a fork. Serve with lemon wedges.

Makes 4 servings (4 oz each).

Nutrition Information (per serving):

Calories: 228

Protein: 20 gm

Fat: 12 gm

Omega-3 fatty acids: 1.7 gm

Adapted from Alaska Seafood Marketing Institute.

Banana Bread


• 3/4 cup ground flax seed

• 1 cup mashed banana

• 1/4 cup apple juice concentrate

• 1/2 cup brown sugar

• 1/4 cup applesauce

• Egg replacer for 2 eggs or 2 eggs (Ener-G Egg Replacer is made from potato starch & tapioca

flour; works wonderfully in baked goods.)

• 1 1/2 cup whole wheat pastry flour

• 1 tsp baking soda

• 1/2 tsp salt

• Additional optional ingredients may include 1/2 cup walnuts, raisins, or chocolate chips.

Mix all ingredients together. Pour in a coated 8”x4” pan. Bake at 350 F for about 40-45 minutes.

Makes 10 servings.

Nutrition Information (per serving):


Calories: 168 Carbohydrate: 29 gm

Protein: 5 gm Dietary fiber: 5 gm

Fat: 4 gm Omega-3 fatty acids: 1.4 gm

Recipe developed by Natalie Ledesma, MS, RD, CSO

Dilled Salmon Salad with Peas


• 1 can (15 oz) salmon, drained

• 1 package (16 oz) frozen peas, thawed

• 1/4 cup lemon juice

• 1/4 cup fresh dill (or 1-2 tbsp dried dill)

• 2 tbsp Dijon-style mustard

• 2 shallots, sliced thinly (about 1/2 cup)

• 1 bunch radishes (about 11 medium), thinly sliced

• 6 cups red leaf lettuce

• Salt and pepper to taste

Drain salmon, place in a mixing bowl, and break into pieces. Prepare the lemon juice, shallots,

radishes, and lettuce. Add to the salmon the peas, lemon juice, dill, mustard, shallots, and radishes.

Mix together gently. Add salt and pepper to taste. Serve salmon mixture over lettuce.

Makes 6 servings (2 cups each).

Nutrition Information (per serving):

Calories: 160

Protein: 17 gm

Fat: 4 gm

Dietary fiber: 5 gm

Adapted from the Women’s Healthy Eating & Living Study (WHEL) at the University of California,

San Diego. Developed by Vicky Newman, MS, RD, WHEL nutrition coordinator.

Neat Loaf


• 2 cups cooked brown rice

• 1 cup walnuts, finely chopped

• 1 onion, finely chopped

• 1/2 medium bell pepper, finely chopped

• 2 medium carrots, shredded or finely chopped

• 1 cup wheat germ

• 1 cup quick-cooking rolled oats

• 1/2 tsp each: thyme, marjoram, sage


• 2 tbsp soy sauce

• 2 tbsp stone ground or Dijon mustard

• Barbecue sauce or ketchup

Preheat the oven to 350 F. Combine all the ingredients except the barbecue sauce or ketchup. Mix for

2 minutes with a large spoon. This will help bind it together. Pat into an oil-sprayed 5×9” load pan and

top with barbecue sauce or ketchup. Bake for 60 minutes. Let stand 10 minutes before serving.

Makes 8-10 servings.

Nutrition Information (per serving):

Calories: 204 Sodium: 248 mg

Protein: 9 gm Cholesterol: 0 mg

Fat: 9 gm

Carbohydrate: 19 gm

Recipe from The Peaceful Palate written by Jennifer Raymond (1996).

Chinese Cabbage and Radish Salad


• 4 cups Chinese cabbage, quartered and then thinly sliced

• 1/4 cup radishes

• 1/4 cup red onion, thinly sliced

• 2 tbsp white miso

• 2 tbsp brown rice vinegar

• 1 tsp maple syrup

• 1 tsp dill, dried

• 2 tbsp sunflower seeds, toasted

With a fork, mix the miso, vinegar, maple syrup, and dill. Mix the vegetables and press with a plate until

submerged in liquid for about 1 hour. Fluff the vegetables to serve and garnish with sunflower seeds.

Makes 4 servings.

Nutrition Information (per serving):

Calories: 64 Carbohydrate: 9 gm

Protein: 2 gm Cholesterol: 0 mg

Fat: 2 gm Sodium: 275 mg

Source anonymous.

Quinoa/Sweet Potato Patties


• 1 1/2 cups sweet potato, peeled and chopped

• 1 cup quinoa

• 2 tbsp parsley, fresh

• 1/2 tsp sea salt


• 2 tsp extra-virgin olive oil

Steam or bake sweet potatoes until done. Drain and mash potatoes. Wash the quinoa well and drain.

Dry toast the quinoa in a skillet until slightly browned. Meanwhile, bring a pot of water to a boil. Add

the toasted quinoa to the boiling water and cook, with lid off, for ~15 minutes. Drain well. Mix the

mashed potatoes and quinoa. Add the parsley and salt. Form 8 patties and place in a lightly oiled pan

over medium-high heat. Cook for about 5 minutes on each side and serve warm.

Makes 8 servings.

Nutrition Information (per serving):

Calories: 125 Sodium: 165 mg

Protein: 4 gm Cholesterol: 0 mg

Fat: 2 gm

Carbohydrate: 22 gm

Recipe adapted from the Vegetarian Resource Group (1997).

Nutrition Resources


How to Prevent & Treat Cancer with Natural Medicine – written by Michael Murray (2002)

The Color Code – written by James Joseph, Daniel Nadeau, & Anne Underwood (2002)

Ultra Metabolism – written by Mark Hyman (2006)


Cancer Lifeline Cookbook – written by Kimberly Mathai & Ginny Smith (2004)

Fat-Free and Easy: Great Meals in Minutes – written by Jennifer Raymond (vegetarian cookbook) (1997)

Lickety-Split Meals – written by Zonya Foco (1998)

One Bite at a Time – written by Rebecca Katz, Marsha Tomassi, & Mat Edelson (2004)

The Peaceful Palate – written by Jennifer Raymond (vegetarian cookbook) (1996)

12 Best Foods Cookbook: Over 200 Recipes Featuring the 12 Healthiest Foods – written by Dana

Jacobi (2005)


Cooking Light Fax: (205) 445-6600

Environmental Nutrition (800) 829-5384

Nutrition Action Health Letter Fax: (202) 265-4954


American Cancer Society (415) 394-7100

American Institute for Cancer Research (800) 843-8114


Caring4Cancer – Provides up-to-date & comprehensive information on the connection between

nutrition & cancer –

Center for Informed Food Choices – Offer cooking classes in the Bay Area that emphasize plantbased


Consumer Lab – Evaluates quality of over-the-counter supplements

Diana Dyer, MS, RD – Breast cancer survivor & dietitian

Ida & Joseph Friend Cancer Resource Center – UCSF Mt.Zion

(415) 885-3693

National Cancer Institute (800) 4-CANCER (800-422-6237)

Oncolink – Provides information regarding clinical trials, newsgroups, psychosocial support, & more.

San Francisco Vegetarian Society – Monthly restaurant outings & pot-luck dinners; call 415-273-5481.


The Vegetarian Resource Group – Provides vegetarian nutrition information & vegetarian recipes




Angiogenesis – The formation of new blood vessels.

Antioxidant – A substance that inhibits oxidation or inhibits reactions promoted by oxygen or peroxides.

Apoptosis – Programmed cell death.

Carcinogenesis – Beginning of cancer development.

Case-Control Studies – An epidemiological study in which a group of, say, cancer patients (cases)

is compared to a similar but cancer-free population (controls) to help establish whether the past or

recent history of a specific exposure such as smoking, alcohol consumption and dietary intake, etc.

are causally related the risk of disease.

Catechin – One of the tannic acids; phytonutrient, specifically, one of the flavonoids found in green tea.

Creatine – An amino acid that is formed in the muscle tissue of vertebrates; supplies energy for

muscle contraction.

Cohort Studies – Follow-up study of a (usually large) group of people, initially disease-free.

Differences in disease incidence within the cohort are calculated in relation to different levels of

exposure to specific factors, such as smoking, alcohol consumption, diet and exercise, that were

measured at the start of the study and, sometimes, at later times during the study.

Eicosanoids – Biologically active compounds that regulate blood pressure, blood clotting, and other

body functions. They include prostaglandins, thromboxanes, and leukotrienes.

Endogenous – Originating from within, as within the body.

Estradiol – A naturally occurring powerful estrogen secreted by the mammalian ovary.

Estrone – A naturally occurring weak estrogen secreted by the mammalian ovary.

Glutathione – A polypeptide produced primarily in the liver; involved in DNA synthesis and repair,

protein and prostaglandin synthesis, amino acid transport, metabolism of toxins and carcinogens,

immune system function, prevention of oxidative cell damage, and enzyme activation.

Insulin – Insulin is a hormone produced by the pancreas in the body that regulates the metabolism of

carbohydrates and fats, especially the conversion of glucose to glycogen, which lowers the body’s

blood sugar level.

Lignans – Phytoestrogens that have a similar chemical structure to estradiol and tamoxifen; appear

to offer protection against breast cancer.

Meta-analysis – The process of using statistical methods to combine the results of different studies.

Mutation – Abnormal cell development.

Nitrosamines – Derivatives of nitrites that may be formed in the stomach when nitrites combine with

amines; carcinogenic in animals.

Phytonutrients – Plant compounds that appear to have health-protecting properties.

Polyphenols – Phytonutrients that act as an antioxidant; compounds that protects the cells and body

chemicals against damage caused by free radicals, reactive atoms that contribute to tissue damage

in the body.

Retinoids – Chemically related compounds with biological activity similar to that of retinol; related to

vitamin A.

Sex hormone-binding globulin (SHBG) – A protein in the blood that acts as a carrier for androgens

and estradiol; inhibits the estradiol-induced proliferation of breast cancer cells.



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crossover trial of black cohosh in the management of hot flashes: NCCTG Trial N01CC1. J Clin Oncol.


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patients. Support Care Cancer. 2007 Aug;15(8):913-21.

353. Tremblay A, Sheeran L, Aranda SK. Psychoeducational interventions to alleviate hot flashes: a systematic review. Menopause.



 Thank you


7 Healthy Leadership Tips by Maria Dorfner


1.  MOTIVATE.  If you’re a leader and hold morning meetings with your team, this is no time for pointing out what people do wrong. Morning meetings should be cheerleading sessions to point out everything your team is doing right, asking them to do more of THAT. If you want your team to be their most productive and make the most sales –you send them out on a high note. There’s a reason production teams have “POST-mortem” meetings.  You ask what went wrong AFTER and get input from the team on what can be done differently the next day to avoid it happening again.  Post, not PRE.  Remember the “M” for Motivate each Morning!


2.  GATHER INPUT.  As a leader, you get your best input from brains in the trenches.  Oftentimes, these people are at the bottom of the totem pole, being paid the least.  But they’re on the firing lines.  If you want your company to avoid a bullet, these are the folks you need to talk to the most.  They know best what’s really going on.  If you’re only talking to people in the Ivory Tower, you’re out of touch. As a leader, you’ll be asked to make recommendations for change. If you’re out of touch, your recommended changes will end up costing the company money in the long-run.  Get feedback on what works from people on the front lines.


3.  RESPECT. Never dismiss or talk down to the people at the bottom of the totem pole.  That means if a dog is on your team, you best treat that dog with the utmost respect.  Today, many of these individuals are college-educated with the potential to be great leaders themselves one day.  Healthy leaders treat Interns and the CEO with the same respect.  I’ve seen leaders who walk through a company and avoid eye contact with anyone who isn’t the CEO.   I’ve also seen leaders who smile, address Interns by name and treat them with the same respect. Guess which leader is healthy and was once an intern himself?  The way to grow respectful leaders in your organization is by being one yourself.  If you’re a CEO and want to know if someone you placed in a leadership position is respecting the troops –ask the troops.  Authenticity can’t be faked.  The reason this is important is I’ve never seen someone who is disrespected ask, “How high?” when asked to jump for that company –your company.


4.  EXERCISE.  People spend a majority of time at the office.  As a healthy leader, ask yourself how you keep your team healthy. By now, your company should have an employee fitness plan in place that is practical.  That means it fits into employee’s daily schedules. Does your company have an in-house gym that employees can utilize?  It’s one of the best investments you can make in assuring your people stay fit and productive in mind and body.  If not, is there an incentive in place like a discount at a local gym that your company can offer employees?  If so, are they given the time to actually use it?  Studies have proven that people’s brains are at their PEAK performance 45 minutes into exercise, even if it’s just walking.  As a leader, you want peak performers on your team. It benefits them. It benefits you.



5.  NUTRITION.  Does your company have a cafeteria?  If so, what are you selling there?  Review the food and beverages you’re selling at your company or in your company vending machines.  You can’t have a healthy workforce if you’re selling sugar, processed foods and death in your place of business.  Don’t believe healthy won’t sell.  That’s the biggest fallacy ever.  Everyone wants to be healthy, feel better and look better from the inside out.  Don’t believe placing one salad that tastes like cardboard is giving your employees a healthy choice.  There are delicious, nutritious adult and kids food and beverages worth exploring to replace the bad.


6.  COMMUNICATION.  Healthy leadership involves healthy communication.  If you’re in a leadership position, take time to get to know people on your team.  Just because Sally or Sam took a job in retail doesn’t mean that’s where their skills or talents best suit the company.  Many people take jobs as a foot in the door to a company OR because it’s the only opening at the time they applied there. When you communicate with people, you may learn Sam is an expert in graphics or Sally is an expert in marketing.  I once consulted with a large company and was told their PR and Marketing departments were underperforming.  I was given permission to “fire ’em all.”  When I talked to each employee individually, I learned each person was merely in the wrong position, i.e. a writer was fixing computers and so forth.  When I moved people around (at no cost to the company) –performance soared through the roof.  People excel when they get to utilize their skills. Once you learn of s person’s skillset, help develop them by giving them the right tools to do the best job.  Then, get out of their way.  Unhealthy leaders think if they shine the spotlight on someone else’s skills, it will take away from their own. That’s the sign of an insecure, unhealthy leader.  Healthy leaders LOVE to shine the spotlight on others because they’re secure in their own worth.  Healthy leaders create winning teams. They may lose a few battles, but these are the teams committed to winning the war. Commit to good health each day.  That one choice can make or break an individual or team.



7.  BALANCE.  Healthy leaders create balance in mind, body, spirit.  They learn the hard way that not making time for one area will affect performance in another area.  Balance includes making time for family, friends and nature.  Yes, nature. It replenishes the soul and inspires creativity and ideas.  A healthy leader can adjust schedules so “burnout” doesn’t happen.  Even a car needs to stop to refuel.  A human being isn’t an inanimate object. It needs to be nourished in mind, body and spirit because we’ve already seen how costly sickness is to companies and the economy. Making balance a part of your company culture is the smart, healthy choice. It prevent illness, burnout and keeps your team at their competitive best maximizing their time so they achieve more in less time.  A healthy leader figures out when maximum productivity or sales occur in their company and allows employees flexibility in their schedule once that max is reached.


leadership2                                                “Your company is only as healthy as your leadership.”  ~Maria Dorfner


headshot  About the Author:  MARIA DORFNER is the founder of of MedCrunch and NewsMD Communications, LLC. She is the recipient of an Outstanding Leadership Abilities award from the National Association of Female Executives (NAFE), Women in Corporate America (WICA) and her alma mater, Pace University in New York City. She began her career as a respected Intern at NBC NEWS in New York City.

Killer Kidney Stones by Maria Dorfner


On November 1, I awoke with sudden, excruciating pain in my lower abdomen.    The kind of pain that unleashes a primal scream.


Cue Bernard Hermann’s music while Norman Bates stabs you repeatedly with a knife.


It also feels like I have to urinate every two seconds, but can’t.  My mind races to what could have caused it.  I drank tap water for the only time the day prior. I also went to my sister’s Halloween party and ate things I don’t normally eat.


Almonds. Did I eat too many?   I workout every day. Did I overdo it?


OR is it the lengthy conversation I had with someone the night before about my disappointment at what a girl in her twenties had said at work. She said she didn’t believe in love.  I fell asleep thinking how sad it is that anyone in the world would believe  that. Was this  psychosomatic?  Did I bring it on myself with my thoughts?


Running to the restroom interrupts my self-recrimination.  I shower and dress for work anyway, hoping it will eventually stop.


It gets WORSE.  I call the doctor and he tells me to come in.  The first question I’m asked is on a scale of 1 to 10 with 10 being the worst pain ever, how bad is it.  I answer 9.  The doctor scribbles something down and disappears for what feels like days.  Did he not hear me?


He returns and hands me a cup.  He tells me to do the best I can. Horrified by the filthy bathroom I run to another one.


Hours waiting for results feels like days. The doc finally returns and says it’s a bladder infection –very common, not to worry.

I tell him it feels more like a kidney stone in my ureter. I point to location. Doc looks at me wondering how I even know such a term.


He reluctantly agrees to take an x-ray.  I’m thinking he’s delighted to 1. prove me wrong and 2. bill me for doing it.


I recall Dad having a kidney stone. He looked like Capt. Kirk  fighting a sentient reptilian humanoid when I drove him to the hospital.


But the doc returns smiling smugly to state  x-ray shows nothing. He sends me home with an antibiotic and still in pain.


I return to work and my daily routine, but the pain worsens. By Nov. 7, it’s unbearable. So much so that I go to the ER.


Again, the doctor asks on a scale of 1 to 10 with 10 being the worst pain you’ve ever felt, how bad is it?


This time, I scream like Nadia Comaneci’s judges in the ’76 Olympics.  TEN! TEN! TEN!  He vanishes for hours, as if I shouted ONE.


Finally, the doc returns. He’s orders a CT Scan.  I’m brought into a room with GE equipment that looks like it must have cost 200K.


I begin to wonder what it will cost, as the machine propels me towards the inner tunnel stopping at my lower abdomen.


When it stops, an OZ sounding voice on a speaker says, “Hold your breath.  Breathe.”  3 x’s. In. Out. 5 min. Done. More my speed.


I wait for results.  Doc returns to say it’s a kidney stone lodged in my ureter–no bladder infection. I refrain from saying told you so.


Instead, I ask if I could see it, and the doctor laughs as though no one has ever asked such a dumb question.


Humor me.  He says okay and I follow him to a computer screen.  I see it. A tiny white speck that has me feeling like I’m giving birth to triplets.


I name them “Pebbles and Bam Bam.” The doc laughs some more.


I am fascinated by how something so tiny could feel like a jagged BOULDER shredding everything in its path.


After the CT scan diagnosis, I’m given a shot in my arm for the excruciating pain I had now been in for 7 days and nights.

They also prescribe Naproxen to widen the thin ureter tube to help the stone dislodge naturally, and Percocet as needed for pain.


I’m then handed 3 white paper funnels with a filter at bottom and told to urinate in it at home.   There are different types of stones, and the only way the doctor can analyze which one you have is for you to catch it while urinating & return the specimen.


They tell me to return if it doesn’t dissolve naturally, which can take hours  or up to three weeks.  Three weeks?!!  Good Golly.  I find this graph later.


Based on it, my .3mm has almost an 80% chance of passing naturally within 12.2 days. Some say a kidney stone less than .5mm in size can dissolve naturally within 3 hours or a few days.  Nice.  I aimed for THAT.   Mission accomplished. 🙂


Based on the stone location, which I only knew because I asked to see it, I have a 75% chance of it departing naturally.

If you are diagnosed with a kidney stone, be sure to ask your doctor:  1. How big is it? 2.  Where is it located? Write it down or ask him to for you because you may be in too much pain to process the information at the time.  It helps you make a best treatment option decision.

Based on the size and location of mine, I feel better determined to give natural birth to Pebbles and Bam, Bam.


The following is recommended to stay comfortable while waiting for a kidney stone to pass:

1.  Prescription pain killer taken as needed or over-the-counter Ibuprofen (recommended dose from your doctor or pharmacist) or take warm baths and use a heating pad on painful areas, as needed.

2.  Drink twelve 8 oz. glasses of water daily, or six 16 oz. bottles of water daily.  Here’s a visual.


I ask what caused it and the doc says they don’t really know what causes kidney stones.


I need to prevent this from EVER happening again, so I want answers.  All he advises is to drink lots of water.


I already drink tons of water! He tells me drink more.  I ask a lot more questions, but get no answers.


What caused it and how can I prevent it from happening again?  I put on my sleuth hat to answer my questions.


The Nancy Drew of Health will get to the bottom of it. But I find a lot of scattered and misleading information.


I find this to be true with most health information out there.  It overwhelms people at the worst time.


It’s scary that the medical community, government and those reporting information don’t always have our best interests at heart.


It’s not that the information isn’t out there. It’s just all over the place, unreliable or contradictory.


For instance, I’ve always heard CRANBERRY JUICE is good for kidney stones.  Not so. It can actually cause them. Very high in oxalate.

More here:


First, here’s a diagram of the Ureter inside your body. They are long thin tubes that carry urine from the kidneys to the bladder.


Muscles in the ureter wall continually tighten and relax forcing urine downward.


They are so narrow that if something the size of a tiny pearl gets lodged in there –it blocks the flow of urine causing intense pain.


1. What are kidney stones?

Kidney stones are a hard mass of crystals that form from minerals in your urine.  This hard mass that can vary in size from a tiny pea to a golf ball can get stuck in the narrow tube connecting your kidneys and bladder. The pain is caused by the wall of the uretra being unable to tighten and relax as it continually does forcing urine downward.  Think of the waves or splashing caused if you suddenly placed a large boulder in a flowing river. Only it’s waves of intense pain inside your body made by something that may be smaller than a grain of rice. Some can be larger with the largest and most painful being the size of a golf ball.


2.  What causes kidney stones? 

According to the National Kidney and Urologic Diseases Information Wearinghouse, kidney stones are caused when the normal balance of water, salts, minerals, calcium, oxalate, phosphorous and other substances found in urine changes.  Family history and not drinking enough fluid is the number one cause.

The real question is what causes the normal balance to change?

I’m a huge fan of examining what you eat first whenever you have ANY health issue.  The process of elimination (or adding what may be needed) is a great way to see if there is a link.  The list of foods to avoid is endless.  See #5.

3.  Who gets kidney stones?  Anyone can get one.  Men are twice as likely to get them as women.

4.  How much water do I need to drink daily? Six 16 oz. or twelve 8 oz. bottles daily.  Add fresh lemon whenever you can.


5.  What do I need to avoid?

  1. Limit caffeine to 300 mg. daily, cup of tea has 80 mg. and 8 oz. coffee has 150 mg.
  2. Pizza
  3. Bread rolls
  4. cheese
  5. black pepper
  6. beats
  7. strawberries
  8. dry beans
  9. peanuts
  10. almonds
  11. cashews
  12. black tea
  13. soy beans
  14. tofu
  15. meat substitutes with soy
  16. dark leafy green vegetables
  17. chocolate
  18. more than 1000 mg. Vitamin C
  19. Cranberries (loaded with oxalates)
  20. hazlenuts
  21. swiss chard
  22. sweet potatoes,
  23. soy products
  24. cured meats
  25. bacon
  26. pickles
  27. sauerkraut
  28. kimchi
  29. soda
  30. sweetened drinks
  31. high levels of Vitamin D (lifeguards get more kidney stones out in sun more)
  32. salty foods
  33. fish liver
  34. food or drinks with high fructose corn syrup
  35. alcohol
  36. pork
  37. grapefruit juice
  38. diuretics
  39. calcium based antacids
  40. reduce sodium to 800 mg. daily
  41. animal protein (meat, fish, eggs)
  42. hot dogs
  43. canned soup and vegetable
  44. luncheon meats
  45. fast food
  46. processed frozen food,
  47. spinach
  48. rhubarb
  49. wheat bran
  50. diet low in carbs
  51. beware of hidden sodium
  52. too much protein
  53. low carbs.
  54. Anything high in sugar, sodium (salt) or protein

 6.  What foods CAN  I safely eat? 

  1. Bananas
  2. Pumpkin seeds (soak before eating)
  3. Avocado
  4. Legumes
  5. Think of meat, fish and poultry as garnish to your email, and not the main course. Buy all meat, fish and poultry fresh.
  6. Bran flakes
  7. Oats
  8. Wheat
  9. Rice
  10. Mango
  11. Add lemon to your water (half a cup of lemon)
  12. Apple cider vinegar
  13. magnesium citrate, magnesium malate, vitamin K2 & A, B6
  14. Carrots
  15. Whole wheat bread
  16. Wheat cereal
  17. Oat bran
  18. Beans
  19. Drink lemonade made from real lemons.
  20.  Calcium in food form only (no supplements) and limit it daily (one yogurt). One woman said she got kidney stones from drinking milk.
  21. Lime, citrus fruits

One study says ONE glass of wine a day can help prevent kidney stones, so add that to the list. I’ll keep updating this list.

According to Dr. Oz:

Foods that can prevent kidney stones:

  1. Bottled water
  2. Oranges
  3. Yogurt
  4. Lentils

Foods that can cause kidney stones:

  1. Black tea
  2. Beets
  3. Spinach
  4. Potato chips

I’m guilty of #3.  I absolutely love spinach with olive oil and garlic.   There still isn’t a lot on the CAN EAT list.

7.  How is a kidney stone treated?   If the stone is smaller than 5mm, it will most likely pass on its own. The doctor can prescribe something to help move it along and something for the pain.  If it is larger than 5mm, the most common medical procedure for treating kidney stones is known as extracorporeal shock wave lithotripsy (ESWL). This therapy uses high-energy shock waves to break a kidney stone into little pieces. The small pieces can then move through the urinary tract more easily. Side effects can include bleeding, bruising, or pain after the procedure. There is also another procedure where they physician can go in with a tube to break up the stone.

8.  How are kidney stones diagnosed?  1. Urine 2. Blood 3. X-Ray 4. CT Scan (most reliable)

  This information is provided by NewsMD Communications, LLC and Healthy Within Network and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. Last reviewed November 22, 2013.                                               

Kidney Stones: Oxalate-Controlled Diet

The Cleveland Clinic Glickman Urological & Kidney Institute, Toll Free 866-223-2273 x1234

Your doctor has ordered a diet to help you decrease the chances of forming calcium oxalate kidney stones. Oxalate is a compound that is naturally present in many foods. The following six factors increase the risk of forming calcium oxalate stones.

1. The amount of oxalate in certain foods.

Although many foods contain oxalate, only nine foods are known to increase oxalate in the urine and kidney stone formation. They are: beets, spinach, rhubarb, strawberries, nuts, chocolate, tea, wheat bran, and all dry beans (fresh, canned, or cooked), excluding lima and green beans. It is best to avoid these foods.

2. The amount of calcium in your diet.

Low amounts of calcium in your diet will increase your chances of forming calcium oxalate kidney stones. You need calcium in your diet to bind oxalate in the intestines. This helps reduce the amount of oxalate being absorbed by your body, so stones are less likely to form. Consuming a moderate amount of calcium every day (2 to 3 servings) from dairy foods or other calcium-rich foods is recommended. If you take a calcium supplement, calcium citrate is the preferred form.

3. The vitamin C content of your diet.

Oxalate is an end product of Vitamin C (ascorbic acid) metabolism. Large doses of Vitamin C may increase the amount of oxalate in your urine, increasing the risk of kidney stone formation. If you are taking a supplement, do not take more than 500 mg of Vitamin C daily.

4. The amount of fluids in your diet.

It is very important to drink plenty of liquids. Your goal should be 10-12 glasses a day. At least 5-6 glasses should be water. You may also want to consider drinking lemonade. Research suggests that lemonade may be helpful in reducing the risk of calcium oxalate stone formation.

5. The amount of protein in your diet.

Eating large amounts of protein may increase the risk of kidney stone formation. Your daily protein needs can usually be met with 2-3 servings a day, or 4 to 6 ounces.

6. The amount of sodium in your diet.

Reduce the amount of sodium in your diet to 2-3 grams per day. Limit eating processed foods such as hot dogs, deli meats, sausage, canned products, dry soup mixes, sauerkraut, pickles, and various convenience mixes.

Use the Food Guide Pyramid to plan a well-balanced diet. Carbohydrates, proteins, and fats are necessary for the proper functioning, maintenance, and repair of your body. In addition to these major nutrients, the body requires water, minerals, and vitamins for good health.

Urology Appointments: 800.223.2273 ext. 4-5600 Nephrology Appointments: 800.223.2273 ext. 4-6771

        This information is provided by Cleveland Clinic and is not intended to replace  the medical advice of your doctor or health care provider.  Please consult your health care provider for advice about a specific medical condition.

© Copyright 2013 Cleveland Clinic. All rights reserved.


  • Kidney stones are one of the most common disorders of the urinary tract
  • Each year in the U.S. people make more than one million visits to their healthcare providers, and more than 300,000 people go to the Emergency Room for kidney stone problems
  • Anyone can get one
  • If you have one you’re more likely to get it again within 7 years
  • 12% men, 6% women
  • Ages 20 to 50
  • Drinking lots of water is the most recommended way to prevent them (when your urine is clear or light yellow you are drinking enough)
  • Men are twice as likely as women to get kidney stones (12% of men develop them in their lifetime)


Effective Natural Remedies For Kidney Stones

kidney stones

8 millimeters (0.31 in) in diameter Kidney Stones

One of the most crucial organs in your body is the kidneys. This is because the kidneys function in not only enabling your body to detox, but get rid of impurities from our blood stream in addition to waste products from your urine. Unfortunately, these vital functions of the kidney can be hampered by numerous ailments. Kidney stone is one of the kidney ailments that affect millions of people worldwide. Whereas it might not be life-threatening as kidney failure the pain that comes with kidney stones can be unbearable.

Therefore, by virtue of being on this page chances are that you are looking for information in regards to natural remedies for kidney stones. If that is the case, then keep reading to the very last paragraph of this article.

Natural home remedies for kidney stones

The best way to get rid of kidney stones is to opt for natural remedies. As such, this article has listed a number of cures for kidney stones that you can use at home and enhance your healing process. Or you can read other natural solutions information on this Kidney Stones Removal Report 

Kidney Stone Removal Report Is Endorsed by Dr. Scott Saunders, M.D.

Lemon juice, raw apple cider vinegar plus olive oil

This is one of the natural home remedies that is not only easily available in your home, but quite efficient when it comes to curing kidney stones naturally. Symptoms such as abdominal pain can be managed by blending olive oil with lemon juice extract. After drinking the mixture, ensure that you have drunk at least 12 ounces of water. Wait for at least 30 minutes before blending 0.5 ounces of lemon juice in 12 ounces of water. Add one tablespoon of raw apple cider vinegar before drinking. Repeat this cycle every one hour until the pain has subsided.

Uva Ursi

This is also another effective natural home remedy for kidney stones. On top of enabling to combat infections that are triggered with the onset of kidney stones, Uva Ursi also functions in assisting in pain reduction and cleansing of the urinary tract. For effective results, it is highly recommended that you take 500 milligram at least twice in a day.

Dandelion Root

The dandelion root has been used for years to treat and manage the symptoms associated with kidney stones. In addition to relieving the pain triggered by kidney stones, organic dandelion root functions in cleansing the urinary tract. For effective results, it is highly recommended that you take at least 500 milligrams of organic dandelion root two times in a day.

Kidney Beans

One of the foods that doctors and other nutritionist recommend for healthy kidneys are kidney beans. Unknown to a majority of people is that kidney stones have been utilized for ages as a medicinal decoction. Remove the beans from the pods and then boil the beans I purified water for at least 6 hours. Take a cheese garment and strain the liquid. Give the liquid a couple of hours to cool down before taking it. To ease the pain, it is highly suggested that you drink the liquid throughout the day.


Diuretic horsetails are easily accessible in the market and can be used in making horsetail tea. By drinking up to 4 cups of horsetail tea in a day, which is an equivalent of two grams of the thyme pill per day will enable you to eradicate the signs and symptoms triggered by kidney stones.

Pomegranate Juice

There is no doubt that pomegranate plant offers immense health benefits. However, more particularly, the juice as well as the seeds of the pomegranate plant can be regarded as a pure natural remedy for kidney stones. Doctors and scientists have attributed this to the acerbic and caustic traits of the plant. For best results, it is highly recommended that you eat organic pomegranate plant or opt to drink freshly extracted pomegranate juice.


Numerous studies have revealed that persons who constantly suffer from recurring kidney stones are less likely to suffer from persistent kidney stones if they took magnesium. For best results, it is highly recommended that you take at least 300 milligrams of magnesium on a daily basis. By doing so, you will be able to deter instances of kidney stones and greatly minimize the signs and symptoms associated with kidney stones.

Organic Celery

Consuming either vegetal or celery seeds will enable you to deter the creation of kidney stones and reduce the signs and symptoms linked with kidney stones.


Doctors and scientists have been able to prove that taking basil tea can greatly enhance the general well-being of your kidneys.

Dietary change

Consuming unhealthy foods can lead to the formation of kidney stones. Hence, you need to curtail on the quantity of energy drinks as well as sodas that you consume. Moreover, you need to steer clear of processed foods plus alcoholic drinks. Furthermore, avoid foods that have high levels of oxalate such as rhubarb, beets, spinach, Swiss chard, soybean, wheat germ, okra, peanuts, and sweets (sugary foods and chocolates).


Make sure you are drinking sufficient water everyday to keep your body and kidneys hydrated specially during summer to prevent the increase chances of an imbalance in your kidneys.


In comparison to other types of vegetables, watermelon is packed with potassium salts. Moreover, it is made up of high water content that helps with hydration. For years, doctors and nutritionists have recommended watermelon as it is regarded as a best diuretic and as such can also be used as natural remedy for kidney stones.


Grapes have long been regarded as the best home therapy for kidney stones. Grapes are made up of unique diuretic importance with respect to their excessive water substances as well as potassium salt. As a result of its minute sodium chloride plus albumin matter, grapes are of great importance when it comes to eliminating kidney issues.

Vitamin B6

Vitamin B6 also commonly referred to as pyridoxine has been found to have exceptional curative success when it comes to curing kidney stones. If you would like to attain lasting results, it is highly recommended that you consume a steady healing dosage of between 100mg and 150 milligram of vitamin B6 alongside other B complex vitamins.

Home remedies for kidney stones are natural and do not trigger unpleasant side effects, it is recommended that you see a general practitioner prior to using them  Or  Click Here To Remove Kidney Stones Painlessly


Additional Resources:
National Kidney Foundation
30 East 33rd Street
New York, NY 10016
Phone: 1–800–622–9010 or 212–889–2210
Fax: 212–689–9261
Internet: http://www.kidney.orgleaving site icon

Oxalosis and Hyperoxaluria Foundation
201 East 19th Street, Suite 12E
New York, NY 10003
Phone: 1–800–OHF–8699 (1–800–643–8699) or 212–777–0470
Fax: 212–777–0471
Internet: http://www.ohf.orgleaving site icon

Urology Care Foundation
1000 Corporate Boulevard
Linthicum, MD 21090
Phone: 1–800–828–7866 or 410–689–3700
Fax: 410–689–3998
Internet: http://www.UrologyHealth.orgleaving site icon


littleme1  About the Author: Maria Dorfner is a journalist who has been researching health since she was a kid.

linkedin110   This is  her first and hopefully her last experience with a killer kidney stone. She is the founder of NewsMD Communications and more recently, Healthy Within Network (HWN). MedCrunch is her blog. She began her professional career with an executive internship at NBC NEWS in New York City.  In college, she covered the health beat and Ivy League Roundup for the college newspaper.  She continued to work at NBC for six years before helping them successfully launch their cable station, CNBC.  She then developed and pitched several health series including Healthy Living,  Lifestyles & Longevity and Healthcare Consumers, which she also senior produced and co-anchored on CNBC.  She wrote, produced and directed “21st Century Medicine” for Discovery Health and has worked as a media consultant/strategist for top hospitals, non-profits and Fortune 500 companies. She was awarded a Medical Reporting Scholarship from the American Medical Association, Media Recognition Award for her series,  “Heart Smart” and numerous other awards for her health reporting and producing.  If you have any health topic you’d like to see explored here, you can email her at Write “Topic for MedCrunch” in Subject line.


New Health Study: Barefoot Running by Maria Dorfner


Today, the Cleveland Clinic News Service (which yours truly helped create and launch) talks about barefoot running vs. shoes.

In 2011, I predicted barefoot running would take off.   Today, more and more runners are leaving their shoes behind.

But a recent study out of Taiwan found that with or without shoes, it’s HOW your foot strikes the ground that increases your chance of injury.   Dr. Susan Joy did not take part in the study, but treats patients at Cleveland Clinic SPORTS HEALTH.


Runner's World magazine, published by Rodale s...
Runner’s World magazine, published by Rodale since 1971 (Photo credit: Wikipedia)

CG: Dr. Susan Joy/Cleveland Clinic Sports Health

Joy says, “The problem is that if you hit the ground really hard with your heel, that bone to bone contact there is not making use of all of the natural shock absorbers in the foot and the lower leg transmitting a lot of force up through the body and that can lead to injuries.“ [:12]








 CG: Dr. Susan Joy/Cleveland Clinic Sports Health

Joy says, “If you’re thinking either a barefoot technology or a minimalist or a lighter weight shoe you just have to make sure you’re paying extra attention to your gait. Because you can’t take a less-efficient gait and just put those on and expect the shoe to make the changes. What the shoe does is it makes you concentrate more on how you’re hitting the ground, which then, slowly over time allows you to adapt better to a new gait pattern.“ [:21]


[VT of Dr. Susan Joy’s soundbites/VO on Pathfire #9139 from Cleveland Clinic News Service]



“Many runners believe shoes have magical properties that they probably lack,” says Amby Burfoot, an executive editor at Runner’s World Magazine.

“Mainly we run in shoes for comfort and safety, reasons that are compelling enough for me.” -excerpt from The Barefoot Root by Zoie Clift

Two years ago, I wrote the following article about barefoot running shoes. It was inspired by my seeing someone wearing them at the gym. Her name was Vena Cook-Clark.  It was the first time I had seen them, and they looked so odd. I asked lots of questions, and thought readers could benefit from what I learned.
Barefoot running shoes have gained popularity since then, since I spotted a lot of them used in the Boston Marathon.  I spotted them in Boston Magazine’s cover photo with runner’s sneakers in the shape of a heart.  I posted the beautiful cover on my Facebook wall, and later that evening Anderson Cooper ended his program with a full-screen shot of it.


Here’s a glimpse back:
 photo:  Vena Cook-Clark on the treadmill in her barefoot running shoes
Running the Distance by Maria Dorfner

Following a good workout, my head was lowered as I sat in the sauna sweating like a turkey on Thanksgiving Eve. My lowered eyes couldn’t help but notice and follow what was the oddest footwear that I’d ever seen at the gym. They sauntered into the sauna like an alien entering a spaceship.

At first, I thought sweat was clouding my vision. As I wiped the dripping water from my weary eyeballs, I realized I wasn’t seeing things. These toes were webbed into a bright royal blue, ribbed, rubber-like material.

English: Vibram FiveFingers Bikila shoes, top ...
English: Vibram FiveFingers Bikila shoes, top view. (Photo credit: Wikipedia)

I instantly recalled a pair of socks fitted for all five toes, which I had seen in stores around the holidays in bright Christmas colors of red, green and white.

I’ve never tried those type of socks on, as I figured it’d take too long to wiggle my fat toes into them. Ideally, when my feet are cold, I like to pull my socks on like a fireman reaching for gear at a four-alarm-fire. No time for messing around. I want my gloves and socks without complications.

But these weren’t socks. Before me were half socks, half water shoes.

When I raised my eyes, sitting beside me was a woman listening to music on her iPod. She probably didn’t want to be disturbed. But my curiosity got the best of me. So, I tapped her on her shoulder to inquire about her odd footwear. What on earth were they? She laughed, and said they were her new running shoes.

Running shoes? Did I hear her right? Were my ears waterlogged from swimming? Apparently not, as she went on to say she absolutely loved them because they made her run faster and they were healthier for her feet.

Healthier? As someone who specializes in health, my interest was peaked even more now. I asked more questions. Her name was Vena Cook-Clark, age 27, and she’d been running as a hobby for 6 years.

Originally, the unusual look and lightness of the shoes grabbed her attention. She read that barefoot running was better for her alignment, and it was enough to make her plunk down the asking price of $100.00 to give them a try.

When she brought them home, her husband joked they looked like she had “alien toes,” but now, she exclaims he wants a pair too. I asked if they were difficult to put on. She said it gets easier after the first few times, and it’s worth the trouble. She added, “It was awkward running with them initially, but after about 2 weeks I got used to them and now want another pair for hiking.”

A woman wears Vibram "Five Fingers" ...
A woman wears Vibram “Five Fingers” shoes. (Photo credit: Wikipedia)

She boasted about how easy it is to toss them in the wash with the rest of her running or working out clothing. She told me they were manufactured by a company named Vibram and told me I could find them on the internet by Googling “Vibram Five Fingers.”

When I got home that evening, I did just that. I instantly found what was called a “Barefoot Movement.” Purists preferred the term, “Minimalist Movement,” since you’re not really barefoot while wearing them. First, I wanted to find out if there really were health benefits to wearing them.

Turns out, a 2010 study from India says children who wore shoes before the age of 6 were more likely to develop flat feet than kids who ran around barefoot. They also had better developed longitudinal arches. Statistically, 8.2% of kids who wore shoes regularly suffered from flat feet compared to 2.8% of barefoot kids. The study was published in The Times of India.

I also learned I’m not the first person to discover this study. In 2009, Christopher McDougall wrote a New York Time’s bestseller called, “Born to Run: A Hidden Tribe, Super Athletes, and the Greatest Race the World Has Never Seen”. It offered an in-depth look at the Tarahumara Indians in Mexico’s Copper Canyons. They ran hundreds of miles over rugged terrain in bare feet, and they ran into their 70’s without any sign of injury. Die-hard runners took note, and made the switch.

English: Bare feet running
English: Bare feet running (Photo credit: Wikipedia)

I wondered what physicians thought about them.

Last year, Harvard scientists, demonstrated that people who run barefoot or with minimal shoes – as people have done for millions of years – often land on their feet in a way that avoids a jarring impact. Less pounding equates to less stress and injury on the foot.

PBS has a video that visually demonstrates what your feet look like when they are running with regular sneaker vs. what they look like when you’re running barefoot or with minimalist sneakers. It’s interesting to note how your feet land on the ground differently. Minimalist shoes have you land on the ball of your foot instead of the heel.

The majority of physicians claim they are indeed better for your feet and “may” prevent injury. There’s that word “may” instead of can, which doctors say when they want to cover themselves. Non-committal, yet they state anyone with plantar fasciitis or any type of foot injury from running may benefit from them.

Physicians offer the following advice if you switch from your regular running sneakers to minimalist sneakers. Start slowly. They recommend you start by using them on trails and grassy surfaces before hitting cement or pavement.

If you’re interested in gaining the benefits of running barefoot, experts say that you need to prepare your feet before you make the switch. You can do so by:

1. fanning your toes, holding for 10 seconds, 10 times a day per foot.
2. Flex your feet for 5 seconds, then release.
3. Trace letters in the alphabet with your feet in mid-air each day.
4. Stand on your tippy-toes, and
5. Side walk.

The above seems like a lot of fancy footwork, but wearers like Vena Cook-Clark rave about them, and won’t be going back to regular running shoes anytime soon. Clark says, “I look at my old running shoes and can’t believe I used to lug those heavy things around in my gym bag. I love these and I run so much faster now and my feet feel so much better afterwards.”

English: Vibram FiveFingers KSO
English: Vibram FiveFingers KSO (Photo credit: Wikipedia)

They were founded by Dan Lieberman and Peter Von Conta. Fitness experts have since made the switch and word-of-mouth about them is rapidly spreading because the footwear causes curious people, like myself, to inquire about them.

Stephen Meade, founder of BigBamboo, LLC says he’s seen a guy wear them to meetings under a suit. He said you can’t help but notice and inquire about them. He did and says the guy who wears them is a marathoner and swears by them. Meade can’t wait to get a pair himself.

Although, Brian Cuban, an avid runner who has run 8 marathons with his best time being 3:27 in the Marine Corps. Marathon says he’d never use them.

Cuban, who in addition to running marathons, is also an attorney, writer, blogger and speaker, believes they will always be a niche item for high distance runners. He doesn’t see them ever catching on mainstream.

Cuban said, “I have too many existing foot and knee issues to make them viable. I need to decrease my strike force, not increase it.”

U.S. Navy Lieutenant Commander Andrew Baldwin, M.D. who is also an avid marathon runner agrees.

Baldwin is not a big fan of minimalist shoes. He says, “They’re correct in theory, but with our overweight society with bone structure accustomed to heavy lifting, it can be dangerous and lead to injury.”

Andy Baldwin, M.D. knows a bit about health and fitness, both professionally and personally. He’s been running since he was a kid, and has completed 35 marathons and 8 iron mans.

Baldwin is a triathlete, humanitarian, U.S. Navy diver and media personality currently serving as a family medicine resident at the Naval Hospital Camp Pendleton in Southern California. He has also served at the Navy’s Bureau of Medicine and Surgery in Washington, D.C. as a spokesman and advocate for Navy medicine.

While in D.C. he assisted the U.S. Surgeon General with a program called Healthy Youth for a Healthy Future and currently serves as an advocate for the Let’s Move Campaign headed by First Lady Michelle Obama. Both of these programs target childhood overweight and obesity.

On a side note, he was also the star of the ABC hit show, “The Bachelor: An Officer and a Gentleman.”

Yet, despite low opinions, sales are on the rise.

Sales for the Vibram Five Finger shoes have tripled every year since their launch in 2006. And sales continue to grow. So these rubber-soled, light as air running shoes may be more than a passing fad within the fitness industry.

The biggest complaint from consumers to date has been that the seams tear after 90-days. Consequently, the warranty on them is you guessed it, 90-days. But, the upside about that is the manufacturer, Vibram, will promptly replace them at no cost if that happens. So far, the customer service has been excellent, and they’ve been around since 2006. The second complaint is blisters. But traditional running shoes can give you blisters too.

The webbed running shoes may look dorky and weird, but they’re super comfortable, like being barefoot, only your feet are completely protected from sharp objects and stones. They also keep your feet warm. If you’re renovating your home and have nails on the floor, they could be a benefit or if you have small children who leave all sorts of things lying around, they could also be a smart substitute for wearing socks around your home.

I also bumped into Vena Cook-Clark at the gym again, and she ran up to me in her Vibrams to tell me she was thrilled to announce she had gotten a second pair for hiking, and that her husband was now sporting a pair, loving them.

Skeptics who may not want to use them for running, are using them for comfort and grip during weight lifting, yoga, bike-riding or plain old walking.

I recently walked through a mall, and couldn’t help but spot them in all the footwear stores. They come in a variety of attractive, vibrant colors for both men and women. When you lift them it’s exciting to feel how light and flexible they are and there is a buzz in stores with people talking about them.

Last month, runners wore them in a 5K race in the Oshkosh Half Marathon. And you can’t walk into an athletic footwear store without seeing them on the shelves. Top brands are starting to get into the race. Nike and New Balance just introduced “Minimalist Sneakers” this week.

Current Top 5 Brands for “Minimalist Sneakers” which cost approx. $100. are:

1. Vibram
2. Nike
3. New Balance
4. Reebok
5. Brooks

As for me, I still want my gloves, socks and sneakers without complications. But I’m willing to give these a try, if only for the light weight for carrying them around. I’m also thinking they’d be great for walking on the beach in the sand. I love the feel of sand of my toes, but there’s always a chance of stepping on something sharp. I like to walk/run by the ocean and these seem like a good alternative to bulky traditional shoes. I also like the non-webbed toe version, which are even lighter in weight than the Vibrams. They’re easier to toss into a beach bag than traditional running shoes. I recently tried Stand-Up Paddle boarding and I could see using them for that as well.

Vibrams weight is 5.7 ounces. The Mizuno Universe 3 (price $119.99) weighs 3.6 ounces and has a closed toe as you’d see on a traditional sneaker, so no alien toes.

As summer approaches, you may see more and more of these minimalist running shoes, and do a double-take as I did. If they are durable and people like them, I believe word-of-mouth will have these minimalist shoes going the distance like a Tarahumara Indian in Mexico’s Copper Canyons.


English: Vibram FiveFingers Bikila shoes, inne...
English: Vibram FiveFingers Bikila shoes, inner side (facing other foot). (Photo credit: Wikipedia)

I also enjoyed The Boston Globe Magazine article, “The Great Running Experiment” by Shira Spring.  Check that out if this is a topic that interests you.

“The human foot is a work of art and a masterpiece of engineering.” – Leonardo Da Vinci


Here’s a link to my original article, “Running the Distance” by Maria Dorfner

Healthy Reflections by Maria Dorfner

A healthy lesson I’d like to share from my youth is never strive for perfection.
I recall my inspiration for perfection in vivid detail. It was the Summer of 1976 in Brooklyn, NY.
I sat on the bright red carpet of my parent’s living room staring transfixed at the TV screen at
someone I then thought was perfect. Nadia Elena Comaneci, one of the best-known Romanian
gymnasts in the world, was awarded a perfect score of 10 in an Olympic Gymnast event. She began
gymnastics in kindergarten. Kindergarten. Talk about getting a flexible leg up on the competition.
She was the first gymnast to perform a double back salto and a double-twist dismount, not to mention
the first ever to successfully perform an aerial cartwheel-back handspring flight series and aerial
walkover.  If you don’t know what that means, doesn’t matter. She did it perfectly is all you ever
need to know.
On July 18, 1976 at the Summer Olympics in Montreal, Nadia’s routine on the uneven bars was
scored at 10.0. It was the first time in modern Olympic gymnastics history that the score had
ever been awarded.  The scoreboards were not even equipped to display scores of 10.0, so her
perfect marks were flashed at 1.00 instead.  The applause from the crowd was triumphant.
She would go on to win six additional 10s from the floor exercise, bars titles and all-around
In case anyone missed it — ABC’s television program, World Wide of Sports replayed
constant s-l-o-w motion montages of Nadia.  In March 1976, she competed in the American
Cup at Madison Square Garden in New York City. She received unprecedented perfect
scores of 10, which signified a perfect routine without any deductions, on a vault in both
the preliminary and final rounds of competition and won the all-around. She also received
10s in other meets in 1976, where she posted perfect marks on the uneven bars and vault.
She was named the United Press International’s “Female Athlete of the Year” for 1975.
She was the 1976 BBC Sports Personality of the Year and the Associated Press’s 1976
“Female Athlete of the Year”. The New York Times headline the next day read:
Gymnast Posts Perfect Marks.
But the headline that would leave the most indelible mark in the mind of this twelve-year-old
was on the August 2, 1976 cover of TIME Magazine. Two words:
There was a lot going on in the world in 1976.  I was a newshound, so I followed it all. 
Lots of stuff I couldn’t control.  For starters, in NYC, the “Son of Sam” pulled a gun from
a paper bag, killing one person and seriously wounding another one.  It would be the
first of a series of attacks that would terrorize the city for the next year. Every night,
my Dad brought home the New York Post with progressively worse covers that
terrified us.  That year, the NJ Supreme Court also removed coma patient,
Karen Ann Quinlin from her ventilator. She died. The first known outbreak of the
Ebola virus happened in Yambuku, Zaire. I was busy researching that too. 
It wasn’t all bad news. It was the Bicentennial, so we were all obsessed with
red, white and blue and all things patriotic. That was fun. Steve Jobs and
Steve Wozniak formed Apple computer.  Exciting. The song,
Hotel California was released by the Eagles.  We were also introduced to
Casey Kasem’s Countdown.  Music was a welcome relief to all the scary stuff,
so I was dancing to things like Kung Fu Fighting and Shake, Shake, Shake. 
I listened to the music while exercising like a maniac indoors.  I couldn’t go
out anyway because the “Son of Sam” might get me. He was after brunettes. 
This worked for my desire to practice every day, so I could be perfect –just
like Nadia.  I couldn’t control scary news events, but I could control me.
It’s no surprise I made cheerleading after they saw my perfect chinese split. 
Afterall, when I wasn’t at school, I was religiously doing my gymnastic routines. 
I wanted to be perfect.  It would take decades for me to undo the damage
those two words left on my brain. Years to learn perfect is the evil of good.
I had to unlearn in order to learn to strive to be healthy, as there is no way to
be perfect AND healthy. Every young gymnast, even Nadia, would later reveal
that obtaining and maintaining that physique led to unhealthy eating habits,
which were detrimental to her health. I didn’t know that then, so I was dieting
to look like her. Parents think kids who are skinny are naturally skinny, so
it doesn’t often raise a red flag. It should. Today, I see young girls who
are way too young to be body conscious, but they’re admiring celebs they
see in magazines that we later learn are airbrushed.  No young girl
or boy should ever be dieting unless it’s under a physician’s care.
Even in business, perfectionism isn’t good.  One of my mentors taught me to
“let it go” and not wait for things to be perfect to do.  Again, perfect is the evil of
good because if you wait for things to be perfect, you’ll miss opportunities.
And things will never be perfect.  If you think in your mind that one thing
or one person is holding you back, well it will be replaced with something or
someone else. Don’t wait for circumstances to be perfect or for anything
to be perfect. Life is unpredictable. 
If it’s good –it’s good to go.
Back to Nadia.  Today, she is a strong advocate on healthy eating. 
Young boys and girls are still exposed to unhealthy images of what their
bodies should look like and it’s detrimental to their health to try to attain that
look. There is no diet in the world that will do for you what good nutrition and daily
healthy habits will do. 
Daily healthy habits include eating nutritious meals and snacks, drinking lots of water,
getting at least 8 hours of sleep each night, taking vitamins, getting fresh air and sunlight,
and exercising an hour each day (some experts say 45 min. is good enough, even if
it’s walking).  Anything extreme is bad.  You are more likely to stick with habits for the
longterm if they do not exhaust you. Your goal should always be living a healthy lifestyle,
rather than reaching a certain weight.  I do not own a scale.  When I was trying to be
Nadia, I must have weighed myself every hour.  Daily healthy habits enable you
to be fit in mind, body and spirit. I also learned to avoid all magazines, books or
TV programs that encourage dieting or have any unhealthy images in them.

And if I should ever grace the cover of a magazine, I want the headline to be these two words:

p.s.  I couldn’t get text or pics to align perfectly tonight, but I’m happily letting that go.  😉
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