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The Girlfriend's Guide to Health will be updated every Tuesday.... Stay tuned dear readers and let me rock your world.

Monday, August 31, 2009

Choose Bike!

Always a fan of labels, I have added another one to my list. I’m a commuter. Dior, Gucci, Prada and Cannondale? I have decided to use my powers for good and now cycle to work. Make no mistake; this was not an immediate decision. FIRST, there was the gear. Shopping for a new bicycle is not an easy task. This is made even more difficult when your last bicycle was a Schwinn Cruiser Deluxe one speed with a banana seat and pink tassels on the handlebars. Apparently, tassels are to a bicycle what socks are to sandals; cute on a child insulting on an adult. Thus tassels be gone, I was in need of a respectable bicycle and a trip to the local specialty bicycle store was made in order to achieve cycling maturity.
Make no mistake I did not “cold call” the bike store and walk in without the faintest idea of what I wanted. I was, at the time, training for my first triathlon and was fully aware that Lance Armstrong had won the Tour de France for the seventh time while riding a Trek. If it was good enough for Lance…
So when the lovely woman at the cycling shop asked if she could help me find something, I spoke with an air of confidence. I knew what I wanted and I knew what I was talking about. I wanted a Trek racing bike. This would seem simple enough to the non-cyclist. Apparently asking for a Trek racing bike at a specialty bike store is like asking for an ice cream cone at Baskin and Robbins.
“What kind of Trek racing bike are you looking for,” the woman asked. Her name was Hannah or Anna, I really can’t remember. I think it was Hannah or at least that it what I called her for the rest of the interaction and she never corrected me either because that WAS in fact her name or she was being polite and desperate for a sale.
“I’d like a really nice Trek racing bike.” I replied confidently. What kind of an idiot did she take me for? No, Hannah/Anna I’d like a piece of crap Trek if you have one?
“Okay,” she said with trepidation knowing full well this was going to be a sale she’d have to walk me through. I should point out that in my defense, Hannah/Anna should have seen this coming. I do not own “sporty clothes” as they are often called. I go shopping in heels and to me “casual wear” could easily be anything formal as long as it paired with a jean jacket. So there I was shopping for my Trek in a fabulous little black dress and a jean jacket. I mean really! Did Hannah/Anna think I actually knew what I was talking about?
“What would you like to use your bike for?” Hannah/Anna asked coming closer to me. It was then that I realized she was very petite. At five feet tall and maybe 90 pounds I could easily take this woman. My confidence immediately grew. She would clearly kick my butt cycling up a an incline but in an arm wrestle I would be the victor.
“I have a triathlon coming up and would like a proper racing bike.” I said with an athlete’s pride. She smiled and I watched her eyes look me up and down. Hannah/Anna was giving me the “you are a triathlete?” look. I get this a lot. I do not have an athlete’s body. Yes I am built more for comfort than for speed however I do get extra points for both effort and fashion. I may not finish in a timely manner but I do finish and pride myself on looking impossibly fresh in the photo afterwards.
“Okay,” said Hanna/Anna, after her once over was complete and she walked to the back of the store to find the first bike for me to try. She emerged a few seconds later and I knew that Hanna/Anna was going to need more than just a little arm wresting contest for me to show her my point of view. There in front of me was a Bumble Bee Yellow Cannondale with black writing and a red seat.
“Hanna?” I said, although the “H” might have been silent, “we need to have a chat.”
“Try it for size.” She said confidently.
“Yah, I don’t think so.” I said surveying the large lemon of a thing.
Allow me to explain...Yellow is the kind of color that is great in food and bad in everything else.
Yellow fruit, fabulous, yellow shirt, not so good. Yellow pie is delicious; a yellow bike is a migraine. And so when my little Hanna/Anna tried to soothe me by suggesting that there were even yellow jerseys to go with the yellow bike, I decided to school her in the colour wheel according to Ali Zentner.
“Hannah, I know you are really trying to help and I am not what you would call knowledgeable in the bike department but I must tell you, I need a pretty racing bike. Black or blue, maybe even turquoise with a lovely accent colour. Something that would look sporty but still is fabulous. Do I look like someone who would be happy on a big bumble bee of a bike?” I was trying to get through to this woman when I looked down at the floor and noticed she was in Birkenstock sandals with, yes, woolen socks in the middle of June.
“Let me get Mike to help you. He is much better with this sort of thing.” She sighed. And with that Hanna/Anna gave up on the sale and on me and walked behind the desk. She turned to the twenty something sitting behind the desk who I could only assume was Mike, pointed in my direction and said “Trek racing”. With that, she picked up a copy of Cycling World magazine and banished me from her memory. Mike was now tag teaming it in her plan and headed in my direction.
“Hey there,” Mike said, “I hear you want a Trek racing bike.”
“Do you guys work on commission?” I asked.
“Yeh,” Mike said.
“Okay,” I answered somewhat vengefully. I was now what my husband would call a “hater”. I was buying a bike from Mike just to give him and not little miss socks and sandals the commission.
Within three minutes, Mike returned from the back with the perfect creamsicle delicious tangerine and white perfection that was to be my Trek.
“Try this one.” He said proudly.
“It’s beautiful.” I said almost with a sigh, “How did you know I wanted a pretty bike?” I asked like a woman opening a Tiffany's box for the first time.
“ My sister is a fashion journalist and I bought her a bike for Christmas. Went through the same thing with her. She has the same purse as you have.” He said shyly.
I did not know what pleased me more; that my new bike fit perfectly, that it really was practical AND pretty, or that there was a fashion journalist out there carrying the same bag as me.
And so my love affair with the bike began. My Trek and I have now been together for over a year. We have shared many highs and lows. I have learned how to signal properly in traffic rather than just swearing at cars about my directional intentions. I have completed a triathlon and lived to tell the tale. I cycled my way through a rain filled Vancouver winter and learned that when you pedal too fast in the rain the water really does fly up your backside and not in a good way. Through a determination bordering on shear stubbornness I have learned how to use “clip in” pedals where you wear special shoes that clip to the pedals of the bike. Truth be told I learned to clip in not for the extra power it offers the cyclist when riding a bike but for the fact that if there was an occasion to buy special shoes- I would NOT be denied. I have fallen off my creamsicle fabulous perfect bike a total of 21 times (all learning how to use the “clip in” pedals) and managed only a nasty scar on my left knee that refuses to heal. I now own four pairs of cycling shorts all with extra padding in the crotch area, two sets of cycling rain gear and all of my cycling jerseys curiously look wonderful with the colour tangerine.
So, when the Archives of Internal Medicine published a study about the results of cardiovascular benefits of commuters I felt all of my hard work would be now justified. The trial done out of Chapel Hill, North Carolina by Dr. P. Gordon-Larsen and colleagues studied young people who commuted to work by walking or cycling over a one year period versus those who drove their cars. This cross-sectional study included 2364 participants enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study who worked outside the home. The study looked at the relationship between walking or biking to work with body weight, obesity, fitness levels, and risk factors for heart disease. A total of 16.7% of participants used any means of active commuting to work. All other things being equal, male commuters had 50% less like likelihood of obesity than men who drove to work. Unfortunately this difference was not observed in female commuters which only proves my theory that God is a woman without a sense of sisterhood. Female commuters however did have significantly greater fitness levels than non-commuters. So as I ride my Trek rain or shine over the Lion’s Gate bridge and back again day in and day out I can rest assured in the scientific knowledge that I am losing absolutely no weight but if ever I decided to have a foot race with the “old me” (the one who used to drive her car to work) I would definitely kick her ass. No, I may not live longer (the evidence remains to be seen, the studies about longevity are still ongoing) but I do feel better about my cycling ability and my relationship with spandex.
As for the future? Studies come and go and science changes as often as hemlines. Health is transient and we all have to do our part. Someday my love affair with all things tangerine will be replaced with a carbon-fibre turquoise Trek that I can neither afford nor justify at this moment. Someday there will be a study that shows that women who cycle to work on said carbon-fibre turquoise bicycles not only live longer but also are easier to live with. And on that glorious day tassels will be affixed to bicycles everywhere and all will be right in the world once more. No one will go hungry and no one will wear leggings ever again. So it is written, so it shall be done.

Monday, August 24, 2009

I Stand by My Beliefs

Herein I shall bear my soul. It has been over a month of this “put-it-all-out-there” emotional “dear diary” confessional, and I do believe the time has come for the other Choo to drop… I do not pee standing up. This I now realize may come as a shock to many. Some of you have shut your browsers in horror or are now perusing E-Talk daily or checking what has been released this week on i-tunes. For my male readers you may sit in wonder that there are in fact women who can urinate in a vertical position to begin with.
Truth be told, and there is nothing stopping me now, in a café, at the movies, hell, even most gas stations, I do sit to pee. This is not always the case. Make no mistake, if the seat is covered in urine, I AM NOT sitting down. Furthermore I, like many of my soul sisters have mastered the art of vertical urination. If the seat is clean and the washroom does not look like a scene from Midnight Express (insert Turkish prison reference here) I will sit down to do my business. Furthermore, I don’t place toilet paper in neat little rows across it. I have many a time HAD to stand, in four inch heels hovered over the bowl with certain desperation reminiscent of childhood diving lessons. There, on the high board peering at the water below, wondering when to take the plunge. Such is the scene in a less than favorable washroom usually a gas station in one of the Prairie Provinces or Middle America; both of which can be avoided if you don’t drive very often.
I figure I am a busy girl. My day is filled with morning walks, daily bike rides, afternoon runs and a host of activities of regular living. Sitting to relieve myself is one of the few times I DO sit down in a day and why should my backside by denied? Now, women talk about many things when in the company of one another, but really, for all of our chatter, urinating practices are not a usual topic. I know this because in pursuit of research, I asked around. Sitting with girlfriends over coffee, or brunch, drinks or whatever girlfriends do, I have spent the last month inquiring into the positional practices of my fellow females while in the act of urinating. Firstly my question of “Do you sit to pee?” was met with considerable shock. Firstly, let me preface this by saying that as a physician I am quite used to asking people personal questions. More importantly, as a physician I am quite used to getting some pretty personal answers. So I was somewhat shocked by the common thread of surprise and even embarrassment that my “seating” question was often met with. Secondly, the question was usually asked of women I know well, some for years. I did not peruse coffee shops for strangers or survey a hotel bathroom taking an exit poll while unsuspecting patrons washed their hands. I asked GOOD girlfriends, many of whom had divulged to me their personal triumphs and heart breaks. But the “do you sit to pee?” was a question I soon realized that was as polarizing as one’s belief in God or political affiliation.
“It’s a question of cleanliness,” one of my “girls” claimed. “you can catch a hell of a lot from a seat, can’t you?”
And so I got to thinking, what can one catch, I mean really catch from sitting on a public toilet seat? In a world where we are almost to the point of conducting studies into the benefit of jumping out of a plane with or without a parachute, I had to know. What is the medical evidence behind sitting or standing to pee?
At first I turned to my patients’ favorite source for all thing medical…. GOOGLE. Make no mistake, I love GOOGLE. She’s like a personal assistant and a favorite aunt who has the answers to everything rolled into the perfect on line search tool. When I need to find directions to a restaurant or to settle an argument on movie trivia with my husband, GOOGLE is my goddess and I will worship her without shame. However, when a patient would rather search GOOGLE for answers about her blood pressure than talk to me (true story- happens all the time), well then, plain and simple, GOOGLE pisses me off. I am what you would call a fair weather GOOGLE. I search when it suits me. When it came to this particular search, GOOGLE was less than helpful. Sure there were 960,002 search items on “what can one catch from a toilet seat?” I made it through the first 32 pages of references to blogs and bullshit websites before declaring my search a bust. This was not before I found three websites selling a detachable female contraption that allows women to pee standing up. It is a cross between a plastic penis and a catheter and was featured on Good Morning America. This, like a terrible car crash, was too much to turn away from but eventually I decided to close the laptop and move on.
Next came Wikepedia to which I have a sincere emotional attachment. I will elaborate on this at another more appropriate time. Safe to say, I do love my Wiki. Solid, dependable and straight to the point, Wikipedia is like your best gay boyfriend who not let you leave the house in stirrup pants no matter what decade you are living in. But unfortunately on the topic of urination, Wikipedia left me somewhat smarter but still full of questions. I did learn that the toilet dated back to Roman times and that in many countries in West Africa women pee standing up. Hell, in some cases even in the streets. However, there was little to be found on the topic of the North American toilet seat as the next source of the plague.
And so there I was at the University of British Columbia Medical School Library doing one hell of a literature search on a perfectly sunny day that should have been spent at the beach. I had just used their facilities (it was only proper) and sat down again to examine the evidence. There is an overwhelming amount of data on what can grow on a toilet seat, but as for catching it, I am terribly reassured. Interestingly it is the flushing of a toilet that disperses the most bacteria and viruses into the air. In fact a landmark study published in 1975 by Gerba, et al. in the Journal of Applied Microbiology showed that the first flush of a toilet after urination or defection releases the most amount of bacteria into the surrounding air via droplet infection (just like when someone sneezes on you). The amount of pathogens (cooties) drops SIGNIFICANTLY with each empty bowl flush after that to the point that after 3 flushes you are dealing with a bowl that has a much bacteria as it did before anything or anyone went near it. The study went on to sample different locations within household and public bathrooms. They sampled 20 different bathrooms, public and private, and swabbed each sample onto agar plates (used to grow bacteria). They then let the plates grow and counted how many plates grew how many different types of bacteria. The study swabbed six different locations in the bathrooms:
3. toilet seat
4. toilet rim
5. flush handle
6. walls
The study took into account which places had any bacteria at all and which had the most types of bacteria growing. The researchers found that the two places that grew the most types of bacteria were the rim of the toilet and the sink. Yes my sisters… the seat of the toilet grew less colonies of bacteria than did the floor but more than the flush handle and the walls.
Always one to give you both sides of the story, there is one case report in the literature of an eight year old girl allegedly catching Gonnorhea from an airport bathroom in Hong Kong, but she was from Texas and the parents could not be reached for comment according to the American Journal of Microbiology.
Finally, all my reading confirms that one should stand AWAY from the bowl during flushing (I love it when science confirms the obvious). It turns out that the flush of the toilet that is the “dirtiest” part of the act. Toilet paper should be covered, eyes shielded and children and handbags in a safe place! Stand AWAY from the bowl and hope for a good immune system.
Speaking of the immune system, let’s talk about hand washing. As someone who touches sick people for a living, I am a big fan of the hand wash. Hell, I’ll devote a whole blog entry to it in the next few months but for now let’s just say it is a good thing. The American Society of Microbiology conducted a Clean Hands Campaign in 2000 that showed that although 95% of Americans say they wash their hands after going to the washroom, only 67% actually did. Surveys of washrooms across major airports in the USA and Toronto (when will America realize Canada is more than just Toronto?) show that if the Olympics were held in an airport washroom, we’d bring home the gold.
Ninety-seven precent of women using Toronto Pearson’s washrooms are washing their hands versus only 59% in San Francisco. I love San Fran, fabulous city! I don’t care if you leave your heart there or your urine sample… wash your damn hands!
There you have it. Sit or squat, flush or not? Proper bathroom hygiene according to the evidence suggests we may have been doing it wrong all these years. We have long thought it was what we did during urination that matters most. Turns out like most things in life, it is about the end game. Be far from the flush and wash your hands!
Bottom line, there are many ways to do many things in this world. We all have our own paths and preferences in life. Mine is not to judge (at least not here, anyways). I’m just here to do my business, flush and leave. My hands are washed, my soul is clean.
With that said I wonder if I could ask the women before me who do stand to pee to abide by the golden rule I learned in grade school,
“If you sprinkle, when you tinkle, be a sweetie, wipe the seatie”.

Tuesday, August 18, 2009

Why is my Diet a Bad Boyfriend?

I was twelve years old when I had my first boyfriend. His name was Michael and, no this is not his real name. (You know who you are, consider me a forgiving soul for giving you and alias) We dated for four months which, when you are twelve is pretty much a lifetime. We had our own song (“I can’t fight this feeling” by REO Speedwagon), our own restaurant, (The Swenson’s Ice cream Parlour on Mcphillips in Winnipeg) and even our own nicknames. (He called me “Ali-cat”) I should have known then and there that the boy lacked vision, but it was 1983 and I was a visibly awkward chubby girl raging through puberty. I could NOT be picky. Michael was a nice guy with cute curly hair and he had the ultimate trump card. He LIKED me. Michael made me feel like I was perfect. On June 7, 1983, he took me to his sisters wedding as his date. I can still remember the pink and grey dropped waist polka dot satin dress I wore. My hair was the perfect “sun-in” orange and I even wore pink fish net tights to match. I had pink rhinestone earrings and a large pink bow on my purse. Overall I looked like a chubby version of Cindy Lauper and I felt perfect. We danced all night and drank whisky sours that Michael’s snuck us from the bar. On a magical night in June when Michael kissed my goodnight, he told me he loved me. I was Cinderella at the ball and his parents’ ’82 Oldsmobile was my chariot. But unlike a fairytale, real life has a morning after. Mine came the day after Michael’s sisters wedding when I had braces put on my teeth. The very next day, I returned from the orthodontist’s office with a mouth full of metal, Michael took one look at his “iron Jawed angel” and broke up with me immediately. Apparently the space between my two front teeth WAS the lesser of two evils. When it came to a headgear and a bit guard, Michael COULD fight that feeling…
And yes dear reader that is when it hit me. I had a BAD boyfriend. My boyfriend was not the Prince Charming I had imagined. He was a twelve-year-old boy who has the attention span of a homing pigeon. He was fleeting and self-centred. He wanted a date for his sister’s wedding not a lifelong partner with a smile less than perfect.
The decades have passed and my braces are long gone. Pink fishnet tights made a brief comeback and have returned to the fashion halls of fame. High school came and went and I realized that orange was not a good hair colour for me. “Sun In” has been replaced with “L’Oreal” and now instead of natural looking highlights, I strive for complete grey coverage.
But through it all I have realized that there have been quite a few BAD boyfriends. We have all had them.
I have realized that the only other constant in my life has been that I have always been on a diet. I started my first diet at the age of ten. My gym teacher proclaimed me fat and sent me home with a list of foods I could eat and a list of foods I was forbidden. From this cam the grapefruit diet of the early eighties followed by ten (yes count them, ten) Weight Watcher’s membership, two Jenny Craigs and a Nutrisystem. Coupled with The Zone, South Beach, The GI Diet, Dr. Phil and Atkins, I like many of my North American sisters have been dieting for decades.
And it is only until recently that I have realized, my diet really is a metaphor for a bad boyfriend. When my diet and I first get together, we have a period of infatuation that borders on the absurd. I think my diet is the best thing that has ever happened to me. I can’t imagine what I did before my diet came along. I will give up nights with friends and dinners out just to be with my diet. I will plan events around my diet’s schedule and dream about the day when my diet and I finally achieve perfect bliss and I DO fit into my skinny jeans. I will walk into a room in my perfect size 28, two hundred dollar boot cuts and my diet and I will make every bitch who every said we would not “make it” cringe with remorse.
But that does not happen. In reality, my diet makes me do all the work while it shits all over me. My diet is aloof and unattainable. It makes me reform my life and give up that which I love in exchange for a sense of self loathing that I could not even pay for. In short I will never measure up with my diet and so after about four weeks together, I know I have to break it off. Then of course comes the usual mourning/euphoria of being free again until I find a new diet to take on with the same gusto. We usually meet online or in a bookstore and pretty soon I am back on the same roller coaster ride. I am pimped out in a grey and pink polka dot dress, taking what I can get until I have braces put on my brains and I sober up.
But somehow, twenty odd years later, after bad boyfriends/diets, I woke up and got off the dysfunctional merry-go-round. Today things are different. I have spent the last eight years not on a DIET, but changing my lifestyle to be one where health comes first. Make no mistake, I am not about to give you another diet to “shack up” with and spiral off out of control. I will however tell you a simplified version about what helped me get off the diet dating cycle and settle down with a relationship with food that makes me feel good about me and my health.
So if any relationship has a set of rules, here are mine:
1. Keep your kitchen safe. Will power is bullshit. Eighty percent of overweight women surveyed are emotional eaters. Having a bad day? Binging on the yogurt and fruit in your kitchen is going to be a lot less damaging on your emotional wellbeing than a bag of Cheesies. Make no mistake, I LOVE ice cream. But I am asking for it if I keep it in my freezer. Want a treat? Get your ass of the couch and buy yourself a cone. I would not be caught dead with a pint of Ben and Jerry’s in my freezer.

2. Exercise daily. Do something every day for at least thirty minutes. Keep it simple. You do not necessarily need the drama of a gym membership and the perfect outfit. Just go for a walk or bike ride or even take a class you night not otherwise do. You’ll be surprised how it keeps your head in the game. Make no mistake, you may never get that “runner’ high” al the skinny broads talk about. Hell I’ve done more than my share of marathons and triathlon and am STILL waiting for it. (I secretly think it is the Robaxacet you take after the race that gives you the “high” they so fondly refer to)

3. Keep a food diary. Studies show that people who keep food diaries automatically regulate their caloric intake and stay on programs longer. There are a variety of online food diary programs that can help you get started. Hell, you have a shoe budget (and if you don’t- get one immediately); you should have a similar attitude to nutrition.

4. Establish a “bare minimum”. What I mean by this is, GET A BOTTOM LINE. You have a bottom line for your relationships with people, get one for your relationships with food. For example, you would not take him back after he slept with your sister, don’t start the day without breakfast. Okay, a bit of a severe comparison, but I needed to make a point. Have a “set of rules” that guides you through your nutritional life just like they do your social life.

So there you have it. We’ve all had our hearts broken, whether it was on the scale or at the roller rink. We’ve all had a diet or a man who made us the ultimate promise and then could not deliver. Make no mistake; blame the Michael’s of the world as much as I blame the “low carb” craze. They could not help themselves. They were just doing what they were supposed to do. By some cosmic curse my diet is supposed to be a BAD boyfriend. How else would I have figured out how good a healthy lifestyle can be?

Tuesday, August 11, 2009

Never judge a woman until you've walked a mile in her Manolos

A Woman’s Right to Shoes…

Truth be told. I have a strange, perhaps excessive appreciation for expensive footwear. Those who know me (decide at will if you will admit to it) will testify that I am a “friend of Manolo B”, to paraphrase at will. I have long maintained that the reason many women share this same shall we say appreciation for shoes is that if they don’t fit- it’s not your fault. The same cannot be said for jeans. Jeans are the fashion worlds equivalent to that snobby chick you went to high school with. You know the one, with the blonde hair and perfect sweater sets? She was clean and shiny and looked good in everything. She was cold and judgmental and standing next to her you felt, well, quite frankly… exposed. Spending two hundred and fifty dollars on a pair of denim pants by earth shattering names like “seven for all mankind” or “citizens of humanity” is just a vacant attempt to align your chakras in a way they never will. Frankly, its just bullshit. Such bliss cannot exist in the denim section of any respectable retail establishment. I never liked the perfect cheerleader in the sweater set in high school and I don’t have the patience for the jeans she now covets. Both leave me feeling like there has to be “something really wrong” hiding under all that façade…

However…. A shoe department really is a different story. A shoe department of any higher end store (you know the ones- where you are on a first name basis…the sound of them just makes you exhale like a hard core Yoga freak…. Neiman’s or Barneys or Holt’s or Saks). There is honesty in shoes. A size 8 IS a size 8 and if it does not fit- it’s not your fault. In Jeans a size 32 is a mocking hurtful cheerleader who picked you last for dodge ball and if you can do the zipper up she is laughing her ass off at you over lunch-hour while you swallow your pain.

This would never happen in the shoe department. First of all, there is a place to sit. And usually those chairs are plush lovely couches in some colour you would never put in your own home for fear of spilling a coffee or a child on it and soiling its perfection forever. Secondly, the carpet is always equally as plush and fabulous and makes you feel like you are in a home filled with love. Finally, on the so-called shelves of this home are the most perfect assortment of four to six in heels (flats be damned I am short girl) in every shape, strap and variety of toe exposure imagined. AND most importantly the stock changes every 3 months.

So I got to thinking about shoes as the next homeopathic answer to subclinical depression. Can four inches of fabulous really be the key to happiness, as we know it? Or are they just another drug that like all other addictions will lead to destruction and desolation? Is it true what they say that a stiletto may increase a woman’s risk for arthritis and patello-femoral syndrome (nasty knee pain)? My shoes are MY THING. So, I thought it best for me to find out if Christian Louboutin is the key to my future salvation or my future knee replacement.

Let’s begin with those bastards at Harvard Medical School, who in 1998 started the whole rampage against the 4-inch heel. Dr. Casey Kerrigan published a study in the Lancet about the effects of high heels on the biomechanics of the knee and ankle. The study consisted of 20 healthy women who were comfortable wearing heels who were then placed in heels and asked to walk at a comfortable speed for 10 metres across a floor. The biomechanics of their knees and ankles were measured and plotted against the same readings they had while walking barefoot. There was a significant increase in the stress at the knee and the ankle compared to walking barefoot in these women. The findings confirm that wearing high-heeled shoes significantly alters the normal function of the ankle. Because of this compromise, compensations must occur at the knee and hip to maintain stability and progression during walking. These findings suggest that most of these compensations occur at the knee. Now, I have known this for years. Ever since I strapped on my first pair of heels and tried to walk the kitchen floor I realized that I was going to have to learn to walk all over again. HOWEVER… like anything worth having in life, you put in the effort…. Hour upon hours of practice, clenched butt cheeks and a decent swagger have made me the 4-inch woman that I am today. The Harvard study however finds that this compensation MAY over time increase the work of the quadricep muscles, prolong the strain through the patella tendon, and prolong the pressure across the knee joint. Therefore this may lead to increased arthritis and patello-femoral syndrome. However the study did not make any full conclusions.

So here are my issues:

1. Is Dr. Casey Kerrigan a man or a woman? Casey is one of those ambiguous names like Kelly or Adrian or Jesse (or even Ali). Are you a chick or a dude? This makes a difference. No sister I know would shamefully attack the temple. Casey, if you are in fact a woman than I surmise you have never owned a pair of Jimmy Choo strappy sandals and should spend some of your Harvard hard earned cash on said shoes immediately. They WILL most definitely change your research focus. However Dr. Kerrigan, if you are a man…. One small piece of advice which I tell my beloved regularly…. to paraphrase one Carey Bradshaw, DON’T MOCK THE SHOES.

2. Data exists from the United Kingdom that places a well-needed platformed heel up the ass of this controversy…. Researchers at Warwick University and Oxford Brookes University investigated the stiletto controversy with the help of 111 women aged 50 to 70, of whom 29 were awaiting knee replacements. Women were asked to report about their taste in shoes, weight, activity levels and other risk factors for arthritis. The final study, published in the Journal of Epidemiology and Community Health in 2005 found no evidence to suggest wearing high heels was linked to knee problems. Indeed, the statistics suggested women who regularly wore 3-inch heels were less likely to be suffering from arthritis. Factors that did influence a women’s risk of arthritis were being overweight before 40, doing demanding physical work and having previous knee injuries. In fact, there was a link between regular dancing in 3-inch heels and a reduced risk of knee problems. Women were also shown pictures of 38 different types of shoe and asked if they had ever worn a particular type regularly, either for work, socially or dancing. Some 55.2 per cent of the women with knee arthritis regularly wore 3-inch heels, as did 67.1 per cent of women with no pain. In other words…. If you wear heels you have a fifty percent chance of them killing your knees. Having spent more than half my shopping hours in the shoe departments of many a respectable store means I am willing to flip that coin…. Finally, Dr. Margaret Thorougood, the lead investigator of this study can be quoted as saying, ““Women who smoke, are overweight and do a lot of heavy housework such as scrubbing are more likely to develop painful knees and arthritis later in life. But women who wear stiletto heels will be reassured to learn that their choice of fashion-before-comfort footwear will not lead to knee joint problems and may even prevent them.”

Ladies…. Let us pray to the goddess that Margaret lives a long and fabulous life filled with guilt free chocolate éclairs and a phenomenal metabolism.

SO there you have it. What the scientific world would call INCONCLUSIVE EVIDENCE. Harvard says my heels will kill my knees and Oxford tells me to wear them with reckless and fabulous abandonment. I will let my readers make their own decision. Safe to say, as far as I am concerned… God save the queen…

Thursday, August 6, 2009

Tell Me Honestly.... Do these Genes make my Cholesterol Look Fat?

Tell me honestly, do these Genes make my cholesterol look fat?

Truth be told, my girlfriends and I talk a lot about getting old these days. I don’t think it is that we hate the concept so much as we can’t believe it is happening. Some of us see forty approaching and are less than thrilled. Others have embraced the idea that forty is the new thirty (I’ll take a case of whatever pills they are on) and embrace the idea full force. To all my thirty somethings out there reading this entry- you may know what I mean. As for my younger readers, although I have nothing but gratitude for your interest in my column, I secretly envy your youth and defiance of all things gravity and suggest you put this article away for a rainier thirty something day.

One of my girlfriends, we’ll call her “Jackie” shares the same birthday with me. Every year we celebrate our “big day” together. As the twenties turned into the thirties and sped towards the forties she and I have blown out the ever growing forest fire on our respective birthday cakes. It was on our thirty fifth birthday that she turned to me and said,

“I don’t care about getting old. You just have to tell me what tests I have to get and at what age.” Her words slurred and she continued to drink the Veuve Cliquot without missing a beat.

“When do we have to get the test done?” she slurred.

“What test are you referring to?” I asked, Feeling the warmth of the overpriced champagne fill my veins.

“You, know the blood fat one, cholesterol thingy.”

At that very moment she blew my buzz. It was then and there that it struck me: We are now reaching the point where a yearly pap smear is the worst of our worries. Furthermore, if Jackie, a smart successful woman of the world did not know when to have her “cholesterol thingy” checked, how many other women out there were passing birthday after birthday with bottle of Veuve, blinded by the bubbles as to when to get their “cardiovascular health” as in order as their shoe closets?

Lets be honest my cyber sisters… we’ll spend a weekend cleaning out a closet between seasons and even plan a week’s worth of “age appropriate” outfits in our head. We are women we plan ahead. It is likely what that extra X Chromosome offers us, the ability for forward thinking. So let’s put all those great girly genes to work and the at least plan for a cholesterol check.

SO, pull out your iPhone/Black berry/Hermes leather hand bound daybook (you go retro girl!) and mark it. Fortieth birthday coming? Get your cholesterol checked.

Here’s the 411 on our “bloody fats”.

A standard cholesterol test is a measurement of three different types of cholesterol.

1. Low Density Lipoproteins or LDL cholesterol is often referred to as “bad” cholesterol. This is likely because LDL cholesterol is most strongly correlated with cardiac risk. The higher the LDL, the higher the risk. Interestingly LDL is also the most genetically determined of all of our cholesterols. In other words, you can pretty much blame your LDL (along with your low self esteem and bad eyebrows) on your parents. The liver makes Eighty percent of our LDL cholesterol. Cholesterol medication, called statins work by interfering in the production of LDL at the level of the liver. LDL undergoes a process called oxidization that allows it to lay down plaques in the lining of our arteries. These plaques are what contribute to heart disease and strokes.

2. High Density Lipoprotein or HDL cholesterol; every relationship has to have two opposing fronts and so bad cholesterol has to have a good cholesterol. This I where HDL comes in. Typically higher in women than in men, HDL acts to protect against the laying down of LDL plaques in the blood vessels.

So if you think about it, LDL is the frat boy who spends the weekend at your house leaving his shit strewn all over your perfect Feng Shui apartment. HDL is the fabulous Romanian cleaning lady who comes over on Monday morning and picks up after the bum, restoring your den of solace to its former perfection.

3. Triglycerides are the third and final component of the cholesterol we measure using a standard cholesterol test. Triglycerides are most strongly affected by the food that we eat and by excess weight and lack of exercise. In addition to certain genetic disorders that increase cholesterol, triglycerides can be raised in the setting of diabetes and excess alcohol use. Want to lower your triglycerides? Omega 3 fatty acids, exercise and a high fibre diet will definitely make an impact. So the next time you want to wash away a bad date with a pint of Haagen daas and three double martinis? Stop, pay homage to you triglycerides and go for a walk instead.

4. Total Cholesterol to HDL ratio. This is the fourth measurement in a standard cholesterol test and it is a ratio of the total cholesterol to good cholesterol ratio. It becomes and important market when looking at risk factor in patients. For example a woman may have high total cholesterol but this could be because her good cholesterol is so high. This would make her ratio of total cholesterol over good cholesterol rather low. It the ratio that is far more significant than the overall number. Think of it like spending your entire clothing budget on a few key pieces. Your credit card bill says you shop like a sailor, but it is only because you have a few fabulous pairs of Louboutins that will universally last a lifetime, and lest we forget the Prada carryall.

So now you are “in the know” when it comes to your cholesterol numbers! Canadian guidelines recommend that all women over forty have their numbers checked and if they are normal, they should be checked every five years. If you have a family history of high cholesterol, diabetes or obesity or have other risk factors for heart attacks and strokes, don’t wait until forty. Get you cholesterol checked at your next annual medical appointment. Talk to your doctor about what your numbers are and where they should be for someone in your risk category. Remember ladies, knowledge and the prefect black cocktail dress are more powerful than you can imagine.

Want more info?

Here are some of my favorite websites on cholesterol and cardiac risk:

Tuesday, August 4, 2009

What does it take?

So we live in an age of instant gratification. But is that all bad? Antidepressant use has doubled in the last 10 years. Did an interview this morning on CKNW talk radio on the rise of antidepressant use in the last 10 years. Immediately the interview put me on the defensive. Am I worried? Is this too much drug? Is this the end of civilization as we know it? About 6 percent of people were prescribed an antidepressant in 1996. This translates to 13 million people. This rose to more than 10 percent or 27 million Americans by 2005. Is this a BAD thing? Hmmmmm let's think.... More people are receiving treatment for a disease... Could be one of four options:
1. More people are being diagnosed with depression and treated
2. More patients are seeking treatment for their disease
3. There are more treatment options available for depression
4. Evil doctors are plotting with the pharmaceutical industry to take over the world through happy pills.

I know that the scientific community needs to constantly question advancements in the area of medicine. It's how we preserve safety as we advance. That being said.... am constantly defending the "evils" of medicine as "more people take pills than ever before". Yes, we are popping a hell of a lot of pills in 2009. High cholesterol? Have a drug for that. Headache- gotcha covered. Cancer- yes there are treatments.... why is it some drug treatments get a "better rap" than others.... Is it directly proportional to what we perceive the disease threat to be? For example- your head is freakin' splitting and you feel like your eyes are going to blow out of your skull. Most people would not think twice to take an aspirin. Make no mistake, I LOVE aspirin! Any drug that can prevent heart attack, a stroke or even colon cancer in some people and still treat a hangover is okay by me professionally and personally. I'm training for a triathlon and I am loving a little anti-inflammatory! My point is when there is immediate pain- the treatment does not come into question. Take cancer for example. I have yet to meet a patient who wants to try what is on the shelf at the local health food store before taking chemo. I think we tend to treat when the threat of pain or death is right around the corner. But when we can "live" with a disease (there's irony for you) we tend to favour disease over treatment. In other words.... cancer=chemo, cholesterol=red rice yeast. So... back to the point..... Americans are taking more antidepressants over the last decade? Good for them. It's about time Americans had something to smile about.