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The smoker's diet dilemma

Quitting can lead to weight gain. But you can have the best of both worlds.

By Evelyn Tribole, R.D., from Lifetimetv.com

It's no secret that smoking is harmful. This nasty habit has been implicated in cancer, strokes, hemorrhages, heart disease,osteoporosis, infertility and digestive disorders -- not to mention premature death. The picture cigarette smoking paints isn't pretty, either: It results in yellowed teeth and increased facial wrinkling.

The reason smoking has all these unpleasant, often downright lethal effects on your body is that it causes oxidative stress in your cells, robbing them of much-needed nutrients and damaging or destroying them. Oxidizing substances trigger the biological equivalent of your body rusting, and there are more than 4,000 oxidizing substances in cigarette smoke!

What smoking steals
First on the list of nutrients that cigarette butts rob from your body is vitamin C. This vitamin is needed for the production of collagen, which protects against bruising and helps absorb iron, among other things. Smokers have 15% to 20% lower levels of vitamin C in their blood than nonsmokers do, putting them at risk for slow-healing wounds. To make matters worse, smokers' diets tend to be lacking in vitamins, particularly C, E and A, as well as carotene. Those who rely regularly on a nicotine fix are also likely to
drink more alcohol, which displaces food in the diet, depriving drinkers of the nutrients meals may contain.

Who's at Risk
While smokers, especially long-term ones, are most at risk for the nutritional and physical harm cigarettes cause, those who don't smoke aren't totally safe -- this is the reason many U.S. cities are banning smoking in restaurants and bars. One recent study looked at the impact of secondhand smoke by placing nonsmokers in a smoke-filled room for 30 minutes. Even this minimal exposure caused a significant decrease of vitamin C levels in the nonsmokers.

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Five Heart-Smart Moves
Besides knowing your risk factors and paying attention to your symptoms, here are a handful of essential healthy-heart steps to take:

Don't smoke! If you do, quit. "This will have the greatest impact in preventing heart disease and stroke," says Rose Marie Robertson, M.D. In addition, avoid secondhand smoke as much as possible.

Eat a healthful diet. That means one that's
low in fat (especially saturated fat) and rich in fruits, vegetables and fiber.

Exercise regularly.
Move your body aerobically for at least 30 minutes, five or more times per week. It'll help control weight and blood pressure.

Lose excess weight. "Obesity is an independent risk factor even when you control for all the others," says Dr. Robertson.

Cut down your risk. It's not enough to just reduce your numbers: Aim for normal blood pressure, cholesterol and blood sugar levels.

A Healthy Heart
Get heart-smart today and every day!

by Stacey Colino

Cynthia Morse never imagined it was possible to have a heart attack in her early 30s. But it happened: In 1999, this mother of two suffered sudden cardiac arrest while shopping at Home Depot. "I keeled over in the carpet aisle," recalls Morse, now 37. "I never thought I'd have something life-threatening happen at such a young age." Fortunately, a nurse happened to be in the store; she administered CPR and got Morse's heart beating again.

Although Morse was in a coma for a couple of days, she recovered fairly quickly; she was in good health overall and didn't have a family history of heart disease. "I suspect that because I'm an active, healthy person, I fared better than I might have otherwise," says Morse. Nevertheless, the experience was a wake-up call, alerting her to the reality that heart problems can strike younger women, too. That's why Morse, who now wears a pacemaker, takes steps to prevent heart disease and so should you!

A Women's Disease, Too
According to the latest statistics, each year 236,000 women die from heart disease, making it the leading cause of death for this group. Yet, a recent survey by the American Heart Association (AHA) revealed that only 34% of women identify heart disease as the primary cause of death for women, and a mere 8% view heart disease as their greatest personal health threat. Why are women so ill-informed? "Statistically, women typically develop heart disease 10 years later than men, but it can happen to younger women," says Rose Marie Robertson, M.D., past president of the AHA and a professor of medicine at Vanderbilt University Medical Center in Nashville. "Unfortunately, both physicians and women have the bias that young women can't have heart disease." In fact, even as the overall cardiac mortality rate has fallen over the past 20 years, it has risen for women. "We haven't focused enough attention on the fact that heart disease starts young. It's very much like osteoporosis: You have to prevent it before it's a problem. You don't build bone after 50 and you don't begin to clear out your arteries either," says Dr. Robertson.

Women and Men Are Different
Although the same risk factors that apply to men high blood pressure, smoking, being overweight or sedentary, and so on also apply to women, some risk factors, such as diabetes, play a greater role in women. "Diabetes leads to a two- to threefold increase in heart disease among men but a three- to sevenfold increase in women," says Lori Mosca, M.D., director of preventive cardiology at New YorkPresbyterian Hospital. What's more, high triglycerides (blood fats) and low HDL (the "good" cholesterol) are stronger predictors of cardiovascular disease in women than in men. Hormonal issues, such as premature or surgical menopause without hormone-replacement therapy or using oral contraceptives if you're over 35 and are a smoker, can also increase a woman's risk.

Symptoms of heart attack or angina can also be different in women than in men, which is one of the reasons why the disease often goes undiagnosed. While chest pain is the most common symptom of heart trouble in both sexes, women are more likely to suffer from shortness of breath, nausea, fatigue or jaw pain, says Dr. Mosca. And since a heart attack can manifest itself as more of an uncomfortable tightness or heaviness than a sharp pain, the experience may pale next to the agony of childbirth and thus go unchecked, notes Robertson. That's why it's essential that women heed symptoms and seek treatment, especially if pain or tightness in the chest lasts longer than five minutes. "Forty percent of women who have their first heart attack die of it," Mosca says. "There's no second chance for them."

What Is It?
Osteoporosis is a disease characterized by low bone mass and structural deterioration and weakening of bone tissue. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. These broken bones, also known as fractures, typically occur in the hip, spine or wrist.

Osteoporosis is a major public health threat. 10 million Americans already have osteoporosis, and 18 million more have low bone mass, which puts them at increased risk for the disease. Eighty percent of osteoporosis patients are women.

With proper treatment, the effects of osteoporosis can be dramatically reduced.

Symptoms
Osteoporosis is often called the "silent disease" because bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump or fall causes a fracture or a vertebra to collapse.

Collapsed vertebrae may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as stooped posture.

Risk Factors
Certain people are more likely to develop osteoporosis than others. Factors that increase the likelihood of developing the disease include:

  • Being female
  • Being Caucasian or Asian, although African Americans and Hispanic Americans are at significant risk as well
  • Having a thin and/or small frame
  • Advancing age
  • Having a family history of osteoporosis
  • Being post-menopausal, including early or surgically induced menopause. Women can lose up to 20% of their bone mass in the five to seven years following menopause, making them more susceptible to osteoporosis.
  • The abnormal absence of menstrual periods (amenorrhea)
  • Anorexia nervosa or bulimia
  • Having a diet low in calcium
  • Using certain medications, such as corticosteroids and anticonvulsants
  • Low testosterone levels in men
  • An inactive lifestyle
  • Cigarette smoking
  • Excessive use of alcohol

Diagnosis
Osteoporosis can also be diagnosed using specialized tests that measure bone density in various sites of the body. A bone density test can:

  • Detect osteoporosis before a fracture occurs
  • Predict your chances of fracturing bones in the future
  • Determine your rate of bone loss and/or monitor the effects of treatment if the test is conducted at intervals of a year or more

Make Your Smile Sparkle
Six ways to keep your teeth and gums in stellar form!

by Eileen Wilde

Need a quick mood boost? Try smiling. Research has shown that flashing a toothy grin even when you don't particularly feel like it can make you feel great. And it can make others feel good about you, too, says Elaine Blechman, a professor of psychology at the University of Colorado. "When you smile, people are more likely to perceive you as friendly, confident and outgoing," she reports.

But cavities, gingivitis and not-so-pearly whites can put a frown on your face. That's why keeping your teeth and gums healthy is so important, says Kimberly Harms, D.D.S., a consumer adviser at the American Dental Association. Toothpaste alone won't give you a sparkling smile, but Dr. Harms shares six steps that will do the job.

1. Keep 'em clean. Brush at least twice a day to remove plaque, which causes tooth decay and gum disease. And don't forget to floss! According to a recent Johnson & Johnson survey, only 66% of women do so regularly. "Flossing is essential to stop cavities from forming between the teeth," says Harms. Mouthwash won't get your teeth clean, but some rinses, such as ACT, contain fluoride, which can strengthen them and help prevent future decay.

2. Get tool-savvy. Arm yourself with a soft toothbrush, toothpaste with fluoride and dental floss. If you hate brushing your teeth, invest in an electric or battery-operated toothbrush, which can help you do more cleaning in less time. And if it's difficult to fit dental floss between your teeth, minimize discomfort and bleeding by using a type that's waxed, or dental tape instead of string floss. Also, look for products that have the American Dental Association Seal of Acceptance, which means they have been independently tested by the professional organization, or ask your dentist to recommend specific products that will work for you.

3. Perfect your technique. Want to be a better brusher? Follow these steps:

  • Hold your toothbrush at a 45-degree angle and gently brush back and forth, using short strokes.
  • Brush for three minutes, which is about the length of a song on the radio. (According to the American Dental Association, most people brush for less than one minute.)
  • Take time to scrub your tongue. Bad breathcausing bacteria like to hide out there.
  • Avoid over-brushing. More than three or four times a day can wear down tooth enamel and irritate gums.

When flossing:

  • Wrap 18 inches of floss around your middle or index finger, or both.
  • Slide the floss between your teeth.
  • Curve the floss around the tooth in a C shape (not diagonally).
  • Gently move the floss up and down.
  • Use a new section of the floss for each tooth so you don't transfer food debris.

4. Stop all-day snacking and sipping. Foods that are high in acid, sugar or carbohydrates such as lemons, candy or potato chips can cause plaque and decay. However, Harms says that the biggest problem is not what people eat, but how often. "The more you snack, the more you expose your teeth to acid and plaque-causing agents," she says. Since brushing your teeth every 10 minutes isn't plausible (and can damage enamel), your best bet is to stick to just one or two snacks a day and trade soda for water, which is also smart for your health.

5. Visit your dentist regularly. Six-month checkups are important, because your dentist can give your teeth a professional cleaning and will spot dental problems that may not be visible to the eye. If you have a toothache, make an appointment right away. "Dental decay is always progressive. When you have a cavity, it only gets bigger," says Harms.

Consider seeing the dentist more frequently if you are:

  • Pregnant. Hormones can lead to a condition called pregnancy gingivitis, which has been linked to preterm labor and low birth weight. It's important to be diligent about brushing and flossing every day.

  • Taking mouth-drying medications. Certain medications including some that treat depression, high blood pressure and allergies can cause dry mouth, which can damage your teeth. "Saliva has antiseptic properties that keep bacteria under control, so when your saliva decreases, the level of decay goes up dramatically," says Harms.

  • A smoker. According to the National Cancer Institute, tobacco use accounts for 80% to 90% of oral cancers. And smokers are more prone to have gum disease, bad breath and tooth discoloration, adds Harms.

6. Look out for serious symptoms. Both canker sores and oral cancer appear as white, ulcerated lesions. So how can you tell the difference? You can't. "If you have a sore in your mouth and it doesn't go away within 10 days to two weeks, have it checked by your dentist," says Harms. If detected early, oral cancer can be treated through surgery, radiation or medication.

Kicking the Habit
The single most important thing you can do for your health is to quit smoking. Turn over a new leaf and say no to tobacco!

by Diane Umansky

For die-hard smokers, saying no to cigarettes is about as tough as it gets. Take it from Lifetime Online community member wjharden, who posts, "I'm thinking about quitting, but I'm going through a lot of things at the moment...so maybe this isn't the right time. Any suggestions?"

The best advice: Don't put off quitting, even if you're stressed. As psychologist Edwin Fisher, Ph.D., a professor of psychology, medicine and pediatrics at Washington University, and a consultant for the American Lung Association, notes, "Fifty percent of all adults who have smoked have quit, including millions who were heavily addicted."

Still, you're more likely to stick with your cigarette ban if you follow a few surefire strategies. Here are key kick-the-habit tricks:

Step 1: Pick a quit date, preferably one that's meaningful to you, such as a birthday or the beginning of a new year. It's a good idea to swear off cigarettes at a time when your life is relatively calm although waiting until you feel completely stress-free may be unrealistic, not to mention an excuse to keep lighting up.

Step 2: Prep yourself. A few weeks before your quit date, think about and jot down your reasons for wanting to quit. Keep the list handy so you can refer back to it at moments when your resolve weakens. Two weeks or so before the big day, start a diary of how much you smoke, noting when and what seems to trigger the urge. (Identifying your triggers can help you head off temptation once you quit.) If, for instance, you tend to smoke when you're out socializing with friends in bars and restaurants, you may want to avoid these types of activities for a while.

Step 3: Indulge in some chemical assistance. Going it alone is only for the truly brave or stupid. Whether you opt for medications such as nicotine replacement therapy, the antidepressant buproprion or a formal smoking cessation program, extra help can make life without cigarettes smoother.

Step 4: Get a little help from your friends. When it comes to quitting, "most people fare better with some coaching," says Linda Hyder Ferry, M.D., M.P.H., president of the Foundation for Innovations in Nicotine Dependence and associate professor of preventive and family medicine at Loma Linda University in California. Ask friends and family to avoid lighting up around you. Find an ex-cigarette junkie to call on when you're in need of a post-quitting pep talk.

Step 5: Go cold turkey. The majority of experts agree that it's the most effective way to go. So when the chosen day arrives, toss your cigarettes even the secret stash behind the hamper. If you can get through the first two weeks without a slipup, you've got a good chance of staying smoke-free. According to Linda Hyder Ferry, M.D., M.P.H., cravings during the first three to four days are the most powerful; on days five to 10, the intensity plateaus, and after that, the hunger for nicotine begins to dwindle. That's when you'll begin to feel better. Really.

Step 6: Shake up your routine. If you always take a butt break with co-workers at lunch, or reach for a ciggie after dinner, change your routine. Take a walk instead of going for a group smoke, and try a few other activities that are incompatible with smoking, such as swimming and cycling. "Exercise will make you feel better about living a healthy life and you won't want to undermine your new habits by smoking," says Dr. Fisher.

Step 7: Don't beat yourself up. Most people quit and relapse several times before they stop smoking for good, so don't be too hard on yourself if you cheat. If you find you're stuck in a pattern of starting and stopping, however, you may want to see a counselor and be evaluated for depression. According to behavior modification specialist Paula Djabbarah, who runs the smoking-cessation program at Presbyterian Hospital of Dallas, some people who find quitting especially tough are actually depressed and don't know it. "Dopamine [one of the body's natural mood-balancers] is released every time you take a drag on a cigarette," she explains. "People who smoke may be doing so to offset depression." Once you treat the depression, kicking the habit may get easier.

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