Real Health Winter 2010

REALHEALTH THE GUIDE TO BLACK WELLNESS

WINTER 2010 $2.99 US REALHEALTHMAG.COM

Is Your SelfEsteem Tangled Up in Your Hair?

Eat More and Lose Weight!

SEXUAL ADDICTION

When You Crave Too Much of a Good Thing ACTRESS

TAMARA TUNIE

Works Hard to Empower Black Girls

How Hepatitis C Almost Cost Me My Life

Natalie Cole

REALHEALTH

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11 9 11

15

editor’s letter

16 COVER STORY

saved by love

buzz

More blacks nipping and tucking to work on their body issues; who has the poorest chance of avoiding HIV; and how close are we to virus-killing microbicide gels?

13

20

24

self-esteem issues

Tamara Tunie helps young girls build their confidence through athletics and academics.

28

hair politics

Does texture dictate your self-worth?

PLUS: products we love, and healthy hair tips you can try

nutrition

Best-bet beverages for healthy drinking; how to eat your fill and still lose weight; feed your hunger and rev up your metabolism

perfectly sensible

Forget the hype; eating a variety of nutritious foods is what’s key to health. PLUS: high-energy foods to fuel your body

fitness

Try a time-saving total body workout; create an on-the-job fitness routine that works

15

Natalie Cole’s harrowing hep C experience is an unforgettable story.

sexual health

Ask the sexpert; precocious puberty primer: what parents should know if their kids mature early

14

16

32

thoughts

Attitude changes; PLUS: how one man pushed past his pain for help

Contributor Question of the Month

What was a defining moment in your life this year?

My father and best friend, Walter Gates II, died on May 28. A born risk-taker, he’d want me to honor his memory by living my life fearlessly.

—Chee Gates

reach out & click!

At realhealthmag.com, you can read more articles; access exclusive, online-only special reports; meet other health-minded black singles; and subscribe ($9.97 for four quarterly issues; you can also call 800.973.2376). Plus, sign up for the Real Health e-mail newsletter to get the latest black health news!

(CITY) DREAMSTIME/ALAIN LACROIX; (VEGETABLES) DREAMSTIME.COM; (COLE) JULIE BROTHERS; (GATES) COURTESY OF CHEE GATES

INTRODUCING

RH CONTENTS

Hey, have you heard the news?

For eligible patients, Merck covers up to $400 on out-of-pocket costs, for each of up to 12 prescriptions.

Introducing the Savings Coupona for ISENTRESS. Eligibility restrictions, terms, and conditions apply.a To find out more, call 1-866-350-9232 or visit isentress.com.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. a For

eligible privately insured patients. Not valid for residents of Massachusetts. Restrictions apply.

Please see full Terms and Conditions on isentress.com.

Copyright Š 2010 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. All rights reserved. 21052655(5)-12/10-ISN-CON

INDICATIONS ISENTRESS is an anti-HIV medicine used for the treatment of HIV. ISENTRESS must be used with other anti-HIV medicines, which may increase the likelihood of response to treatment.

The safety and effectiveness of ISENTRESS in children has not been studied.

It is important that you remain under your doctor’s care.

ISENTRESS will NOT cure HIV infection or reduce your chance of passing HIV to others through sexual contact, sharing needles, or being exposed to your blood.

IMPORTANT RISK INFORMATION A condition called Immune Reconstitution Syndrome can happen in some patients with advanced HIV infection (AIDS) when anti-HIV treatment is started. Signs and symptoms of inflammation from opportunistic infections may occur as the medicines work to treat the HIV infection and strengthen the immune system.

Call your doctor right away if you notice any signs or symptoms of an infection after starting ISENTRESS. Contact your doctor immediately if you experience unexplained muscle pain, tenderness, or weakness while taking ISENTRESS. This is because on rare occasions muscle problems can be serious and can lead to kidney damage.

When ISENTRESS has been given with other anti-HIV drugs, side effects included nausea, headache, tiredness, weakness, trouble sleeping, stomach pain, dizziness, depression, and suicidal thoughts and actions.

Rash occurred more often in patients taking ISENTRESS and darunavir together than with either drug separately, but was generally mild.

You are special, unique, and different from anyone else.

And so is your path to managing HIV. When you’re ready to start HIV therapy, talk to your doctor about a medication that may fit your needs and lifestyle.

In clinical studies lasting 96 weeks, patients being treated with HIV medication for the first time who took ISENTRESS plus Truvada: Had a low rate of side effects — The most common side effect of moderate to severe intensity (that interfered with or kept patients from performing daily activities) was trouble sleeping — This side effect occurred more often in patients taking ISENTRESS plus Truvada (4%) versus Sustiva plus Truvada (3%) Experienced less effect on LDL cholesterol (“bad” cholesterol) — Cholesterol increased an average of 7 mg/dL with ISENTRESS plus Truvada versus 21 mg/dL with Sustiva plus Truvada

Ask your doctor about ISeNTReSS. Not sure where to start? Visit isentress.com/questions

People taking ISENTRESS may still develop infections, including opportunistic infections or other conditions that occur with HIV infection.

Tell your doctor about all of your medical conditions, including if you have any allergies, are pregnant or plan to become pregnant, or are breast-feeding or plan to breast-feed. ISENTRESS is not recommended for use during pregnancy. Women with HIV should not breast-feed because their babies could be infected with HIV through their breast milk.

Tell your doctor about all the medicines you take, including prescription medicines like rifampin (a medicine used to treat infections such as tuberculosis), non-prescription medicines, vitamins, and herbal supplements.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

For more information about ISENTRESS, please read the Patient Information on the following page.

Need help paying for ISENTRESS? Call 1-866-350-9232

Copyright © 2010 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. All rights reserved.

21052250(6)(110)-11/10-ISN-CON Sustiva is a registered trademark of Bristol-Myers Squibb Truvada is a registered trademark of Gilead Sciences, Inc.

Patient Information ISENTRESS ® (eye sen tris) (raltegravir) Tablets Read the patient information that comes with ISENTRESS1 before you start taking it and each time you get a refill. There may be new information. This leaflet is a summary of the information for patients. Your doctor or pharmacist can give you additional information. This leaflet does not take the place of talking with your doctor about your medical condition or your treatment.

What is ISENTRESS? • ISENTRESS is an anti-HIV (antiretroviral) medicine used for the treatment of HIV. The term HIV stands for Human Immunodeficiency Virus. It is the virus that causes AIDS (Acquired Immune Deficiency Syndrome). ISENTRESS is used along with other anti-HIV medicines. ISENTRESS will NOT cure HIV infection.

• People taking ISENTRESS may still develop infections, including opportunistic infections or other conditions that happen with HIV infection.

• Stay under the care of your doctor during treatment with ISENTRESS. • The safety and effectiveness of ISENTRESS in children has not been studied.

ISENTRESS must be used with other anti-HIV medicines.

How does ISENTRESS work?

• ISENTRESS blocks an enzyme which the virus (HIV) needs in order to make more virus. The enzyme that ISENTRESS blocks is called HIV integrase.

• When used with other anti-HIV medicines, ISENTRESS may do two things: 1. Reduce the amount of HIV in your blood. This is called your “viral load”.

2. Increase the number of white blood cells called CD4 (T) cells.

• ISENTRESS may not have these effects in all patients.

Does ISENTRESS lower the chance of passing HIV to other people?

No. ISENTRESS does not reduce the chance of passing HIV to others through sexual contact, sharing needles, or being exposed to your blood.

• Continue to practice safer sex.

• Use latex or polyurethane condoms or other barrier methods to lower the chance of sexual contact with any body fluids. This includes semen from a man, vaginal secretions from a woman, or blood.

• Never re-use or share needles.

Ask your doctor if you have any questions about safer sex or how to prevent passing HIV to other people.

What should I tell my doctor before and during treatment with ISENTRESS? Tell your doctor about all of your medical conditions. Include any of the following that applies to you: • You have any allergies.

• You are pregnant or plan to become pregnant.

- ISENTRESS is not recommended for use during pregnancy.

ISENTRESS has not been studied in pregnant women. If you take

ISENTRESS while you are pregnant, talk to your doctor about how

you can be included in the Antiretroviral Pregnancy Registry.

• You are breast-feeding or plan to breast-feed.

- It is recommended that HIV-infected women should not breast-feed their infants. This is because their babies could be infected with HIV through their breast milk.

- Talk with your doctor about the best way to feed your baby.

Tell your doctor about all the medicines you take. Include the following: • prescription medicines, including rifampin (a medicine used to treat some infections such as tuberculosis) • non-prescription medicines • vitamins • herbal supplements Know the medicines you take.

• Keep a list of your medicines. Show the list to your doctor and pharmacist when you get a new medicine.

How should I take ISENTRESS? Take ISENTRESS exactly as your doctor has prescribed. The recommended dose is as follows: • Take only one 400-mg tablet at a time.

• Take it twice a day.

• Take it by mouth.

• Take it with or without food.

Do not change your dose or stop taking ISENTRESS or your other anti-HIV medicines without first talking with your doctor.

If you fail to take ISENTRESS the way you should, here’s what to do: • If you miss a dose, take it as soon as you remember. If you do not remember until it is time for your next dose, skip the missed dose and go back to your regular schedule. Do NOT take two tablets of ISENTRESS at the same time. In other words, do NOT take a double dose.

• If you take too much ISENTRESS, call your doctor or local Poison Control Center.

Be sure to keep a supply of your anti-HIV medicines.

• When your ISENTRESS supply starts to run low, get more from your doctor or pharmacy.

• Do not wait until your medicine runs out to get more.

What are the possible side effects of ISENTRESS? When ISENTRESS has been given with other anti-HIV drugs, side effects included: • nausea • headache • tiredness • weakness • trouble sleeping • stomach pain • dizziness • depression • suicidal thoughts and actions Other side effects include rash, severe skin reactions, feeling anxious, paranoia, low blood platelet count.

A condition called Immune Reconstitution Syndrome can happen in some patients with advanced HIV infection (AIDS) when combination antiretroviral treatment is started. Signs and symptoms of inflammation from opportunistic infections that a person has or had may occur as the medicines work to treat the HIV infection and help to strengthen the immune system. Call your doctor right away if you notice any signs or symptoms of an infection after starting ISENTRESS with other anti-HIV medicines.

Contact your doctor promptly if you experience unexplained muscle pain, tenderness, or weakness while taking ISENTRESS. This is because on rare occasions, muscle problems can be serious and can lead to kidney damage.

Rash occurred more often in patients taking ISENTRESS and darunavir together than with either drug separately, but was generally mild.

Tell your doctor if you have any side effects that bother you.

These are not all the side effects of ISENTRESS. For more information, ask your doctor or pharmacist.

How should I store ISENTRESS? • Store ISENTRESS at room temperature (68 to 77°F).

• Keep ISENTRESS and all medicines out of the reach of children.

General information about the use of ISENTRESS Medicines are sometimes prescribed for conditions that are not mentioned in patient information leaflets.

• Do not use ISENTRESS for a condition for which it was not prescribed.

• Do not give ISENTRESS to other people, even if they have the same symptoms you have. It may harm them.

This leaflet gives you the most important information about ISENTRESS. • If you would like to know more, talk with your doctor.

• You can ask your doctor or pharmacist for additional information about ISENTRESS that is written for health professionals.

• For more information go to www.ISENTRESS.com or call 1-800-622-4477.

What are the ingredients in ISENTRESS? Active ingredient: Each film-coated tablet contains 400 mg of raltegravir.

Inactive ingredients: Microcrystalline cellulose, lactose monohydrate, calcium phosphate dibasic anhydrous, hypromellose 2208, poloxamer 407 (contains 0.01% butylated hydroxytoluene as antioxidant), sodium stearyl fumarate, magnesium stearate. In addition, the film coating contains the following inactive ingredients: polyvinyl alcohol, titanium dioxide, polyethylene glycol 3350, talc, red iron oxide and black iron oxide.

IMPORTANT: Take ISENTRESS exactly as your doctor prescribed and at the right times of day because if you don’t: • The amount of virus (HIV) in your blood may increase if the medicine is stopped for even a short period of time.

• The virus may develop resistance to ISENTRESS and become harder to treat.

• Your medicines may stop working to fight HIV. • The activity of ISENTRESS may be reduced (due to resistance).

Distributed by: Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. Whitehouse Station, NJ 08889, USA

Registered trademark of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. Copyright © 2010 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.

Revised June 2010 9795110

1

EDITOR’S LETTER REAL HEALTH EDITOR-IN-CHIEF

Kate Ferguson

Who’s Responsible for Your Health?

MANAGING EDITOR

Jennifer Morton SENIOR EDITOR

Laura Whitehorn ASSOCIATE EDITOR

Cristina González

W

ASSISTANT EDITOR

hen I read about “Take Your Man to the Doctor,” it really spiked my blood pressure.

This is the recent campaign launched by Brooklyn’s borough president, Marty Markowitz, calling on New Yorkers to get the men in their lives to visit the doctor for an annual checkup and to cultivate a relationship with a health care giver.

My initial reaction was, Uh-oh, here we go again: another biological mandate for the ladies. Yes, I know. Women are supposed to be born “nurturers.” But why can’t men be held accountable for nurturing themselves?

What’s more, don’t psychologists warn women to avoid “mothering” men, which confers the kiss of death on their relationships? Now I was really annoyed. Can’t folks make up their minds what role they’d like women to play? And isn’t it difficult enough for women to stay on top of their own health? Now they’re being asked to assume responsibility for another adult’s health too?

The impetus for the annual program is this: According to a 2009 report from the Centers for Disease Control and Prevention (CDC), men ages 18 to 44 were 70 percent less likely than women to visit a physician.

The report also indicated that men were 80 percent less likely than women to have a regular source of health care.

In 2006, Markowitz became one of these

Willette Francis COPY EDITOR

Trenton Straube RESEARCHER

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Smart + Strong Publishers of POZ and POZ.com PRESIDENT AND COO

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EXECUTIVE VICE PRESIDENT AND PUBLISHER

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ADVISORY EDITOR

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ADVISORY BOARD

Lee SaintMartin, MS, IIPA, CN, ND, naturopath; Goulda Downer, PhD, RD, CNS, and Nutrition Services, Inc.; Yuan Wan, Licensed Acupuncturist and Doctor of Traditional Chinese Medicine; Dr. Rachael Ross, MD, PhD, sexologist; Lovell Harris, MD, internist; Terrie Williams, mental health advocate; Xavier Artis, campaign creator, Stay Strong: Healing Starts With Us (HSWU)

Here’s to your health, JOAN LOBIS BROWN

Issue No. 24. Copyright © 2010 CDM Publishing LLC. All rights reserved.

No part of this publication may be reproduced, stored in any retrieval system or transmitted, in any form by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the publisher. If you are an individual or organization and would like to subscribe to Real Health, go to real healthmag.com or call 800.973.2376.

Send feedback on this issue to info@ realhealthmag.com or Real Health, c/o Smart + Strong, 462 Seventh Ave., 19th Floor, New York, NY 10018.

statistics. He experienced chest pains but initially refused to go to the doctor, thinking it was just something he ate. Later, when the pain returned, Markowitz’s wife insisted he go to the hospital. That visit landed him on the operating table where doctors placed two stents in his coronary artery to unblock the blood vessel and restore normal blood flow.

Although I sympathize with Markowitz, if an adult refuses to take control of his or her health and suffers because of it that’s called consequences. I know this may sound harsh to some, but it’s what happens when people make poor choices.

But Markowitz suggests nagging, dragging, cajoling or enticing men into going to the doctor. My answer is: Give us women a break. Why should one adult resort to any of these measures to convince stubborn and irresponsible people to take care of themselves?

Then I read more about the campaign online and discovered a few more details about Markowitz’s program. The initiative wasn’t just aimed at women. The borough president was being infinitely more politically correct. He urged anyone in a romantic relationship—straight, gay or those with multiple partners—to get his or her man to the doctor.

Well, OK, so that made a difference— slightly. But I was still PO’d. (He also didn’t ask men to reciprocate and return the favor to their women.) The point is that part of being an adult means making decisions for yourself and not expecting someone else to be responsible or accountable for your life—not even your doctor’s appointments.

By that definition, I think what we really need is a campaign called, “Take Yourself to the Doctor.”

Can someone please send me a reminder?

Kate Ferguson, Editor-in-Chief katef@realhealthmag.com

realhealthmag.com

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Updated guidelines* include starting HIV medicines at 500 or less T-cells.

My initial thought

was to wait until I started feeling sick.

Now I know, for me

TREATING HIV SOONER, IS BETTER.

Considering HIV treatment earlier may improve your chances of living a healthier life. Starting HIV medicines when your T-cell count is 500 or less is one of several factors to consider, because it may help preserve your immune system and possibly avoid some long-term complications. Talk to your doctor today about a plan that may lead to a longer, healthier life.

TAKE THE NEXT STEP. GO TO

hivtreatmentispower.com * Depar tment of Health and Human Ser vices ( DHHS )

Š 2010 Gilead Sciences, Inc. All rights reserved. UN5139 07/10

BUZZ

LET’S FACE IT

DREAMSTIME.COM

In the past, the notion of altering our God-given ethnic features was considered an affront to our blackness. But times are a changin’.

When Heidi Mathurin, 27, an AfricanAmerican administrative assistant in a plastic surgeon’s office, decided to undergo rhinoplasty (nose reshaping) in December 2009, her self-esteem was not on the operating table. “I admit that I was worried about what people would think. But I saw firsthand that it was possible to have the procedure and still look like me,” she says.

Overall, the American Society of Plastic Surgeons reported a 166 percent increase in the number of African Americans who underwent any kind of plastic surgery between 2000 and 2009. Suffice it to say, the taboo of going under the knife—or the needle— is fading as fast as the wrinkles from Joan Rivers’s 100th nip and tuck (OK so we’re exaggerating).

“Compared to 10 years ago, African Americans boast a more progressive standard of living,” says Samieh Rizk, MD, director of Manhattan Facial Plastic Surgery. About 90 percent of his black

patients request rhinoplasty, he says. In psychology at Bucknell University in response to the demand, he’s designed Lewisburg, Pennsylvania. “Making specific implants and surgical graphs structural tweaks to your appearance for African-American patients that won’t help you resolve issues of identity maintain the ethnic integrity of the nose or Afrocentricity—it doesn’t change while achieving a desirable, natural- who you are.”

What’s more, altering your appearlooking result.

“The days of having a cookie-cutter, ance may cause self-image confusion if Michael Jackson-like nose job are over,” you’re not secure in who you are beforesays Emily Pollard, MD, FACS, solo hand. “Have realistic expectations and practitioner and chief of plastic surgery intentions going in,” Wade suggests.

Meanwhile, Mathurin’s surgery got at Lankenau Hospital in Philadelphia. her a more defined nose bridge, “Both African Americans and Are more shapelier nostrils and eyes and surgeons now recognize that surAfrican cheekbones that scream, “We’ve gery should balance the face and Americans arrived!” She’s also received posenhance ethnic beauty, rather getting snippy? itive support from friends, family than make you look like someone and unexpected sources. you’re not.”

“People ask if I’ve done something Although we can have both surgical refinement and racial authenticity, ‘different,’” Mathurin says. “When I tell potential wrinkles may still lurk beneath them I had a nose job, they say they’ve thought about doing it, too, that mine the surface.

“Blackness is not identified by our looks so natural. I don’t regret doing it physical features alone,” says T. Joel for a second.” And, honestly, why —Chee Gates Wade, PhD, chair of the department of should she? realhealthmag.com

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BUZZ

WAITING FOR THINGS TO GEL Now that studies show a vaginal microbicide can lower a woman’s risk of contracting HIV, when exactly can we get a prescription?

U.S. heterosexuals living in urban poverty—regardless of race or ethnicity— face alarming rates of HIV.

M

oney can’t buy you love—but it might lower your risk of HIV/AIDS. A federal report found that heterosexuals living in U.S. urban poverty face a 2.1 percent HIV prevalence rate—that’s more than 20 times higher than their straight counterparts in the rest of the nation.

In the overall U.S. population, the HIV prevalence rate for blacks is eight times that for whites, and the rate for Latinos is three times that for whites. But in areas of urban poverty, the differences evaporate and everyone faces elevated HIV prevalence.

As Paul Denning, MD, MPH, an epidemiologist at the Centers for Disease Control and Prevention and coauthor of the report, sums up: “The lower a The HIV person’s socioeconomic status, the higher the HIV prevalence infection rate.” rate among Why? Because impoverished communities bear the burden of poor health care infrastructure, high U.S. heteroincarceration rates, unstable housing and employsexuals who ment, addiction and domestic violence—all live in urban contributors to HIV risk, explains Sharen Duke, MPH, who heads AIDS Service Center NYC, which poverty. primarily deals with clients who are impoverished.

This is more Plus, high HIV prevalence means that poor folks than 20 who engage in seemingly low-risk behavior—women in monogamous relationships, for example—are more times greater likely to contract the virus than those who engage in than the rate riskier behavior but don’t live in poverty. among all The stats in the CDC report are alarming because 46 percent of blacks live in poverty, compared with heterosexuals 40 percent of Latinos and 10 percent of whites. in the This means it may be best to focus HIV intervencountry. tions on entire urban neighborhoods and not just on Source: “Communities in at-risk groups. After all, as Duke says, “Where you Crisis: Is There a Generalized HIV Epidemic in live may determine your likelihood for HIV infection.”

Impoverished Urban Areas of the United States?”

—Trenton Straube 1 2 R E A L H E A LTH WIN T E R 2010

I

realhealthmag.com

Real slick: anti-HIV gels

(CITY) DREAMSTIME.COM/ALAIN LACROIX; (GEL) DREAMSTIME.COM

Financial AIDS

It might be awhile before these gels are available, says Tim Horn, president and editor-in-chief of AIDSmeds.com. “Though efficacy is a key variable that’s important to drug approval agencies, so too is safety.

We need to know more about problematic effects of promising microbicides, including the risk of drug resistance in women who do contract HIV.” Since researchers announced their groundbreaking study results (a gel containing a drug that fights HIV reduced male-to-female HIV transmission 39 percent) at the XVIII International AIDS Conference in Vienna this summer, they’ve been unable to raise the $100 million needed to continue the research.

“Conducting very large clinical trials costs hundreds of millions of dollars,” Horn says. “Researchers need to keep working closely with HIV prevention activists to ensure that current streams of funding are at least maintained. It may also be necessary to increase pressure on pharmaceutical companies producing the drugs being used in microbicides.”

And should microbicides get approved for manufacture, companies will need time to construct marketing campaigns to make consumers want to use these gels. Plus, gel makers will have to find ways to meet many real-world adherence challenges.

Until then, the lube won’t be in the tube anytime soon.

—Kate Ferguson

SEX

TOO GROWN TOO SOON?

(EMBRACE) ISTOCKPHOTO.COM; (ROSS) COURTESY OF RACHAEL L. ROSS, MD

New research suggests children are starting puberty at an earlier age.

Today, some girls begin physically maturing when they’re as young as 7 or 8 years old. That’s much earlier than girls entered puberty 10 to 30 years ago, according to a recent study published in the journal Pediatrics. The problem is that early puberty could signal a medical abnormality and affect a child’s psychological development.

Simply defined, puberty is a complex hormonal process that triggers the development of sexual characteristics. Early puberty is divided into two types: precocious or peripheral. In the most common type, precocious puberty, there are no explanations for a child’s early development and no medical reasons to stop it. But with peripheral puberty, often something more sinister, such as a cyst or tumor, may jump-start the process. In these cases, doctors step in to halt the onset.

The condition is uncommon— although it occurs more often in girls than boys—and is treatable with hormone injections or implants, says Luigi Garibaldi, MD, a professor of pediatrics at the University of Pittsburgh School of Medicine.

How much should parents worry if they notice signs of early puberty in little Susie or Mike? If the onset is abnormal, certain physical and psychological problems may arise. “Kids may experience a rapid growth spurt and end up short,” Garibaldi says.

“Also, research shows girls who go through early puberty may tend to engage more in risky behavior.”

But research in this area is new and not definitive, Garibaldi warns.

The best advice? Check with your pediatrician if you notice any early development. —Cristina González

Ask the Sexpert Sexologist Rachael L. Ross, MD, PhD, a.k.a. Dr. Rachael answers your questions.

How do you recognize sexual addiction?

Sex becomes an addiction when people lose control over their ability to choose to have sex. They become obsessed with it and will go through any extremes to have sex and the pleasurable feelings associated with it.

Also, sex addiction by definition is not limited to physical acts with a partner.

It may involve masturbation, pornography and even repetitive thoughts. The message sent to a sex addict’s brain is that sex or sexual imagery is more important than food, family, relationships and money.

While it is natural to crave sex and sexual contact on a daily basis, it is not healthy when sex causes the following: ■ You are repeatedly late to work because of sexual practices.

■ You spend large sums of money on pornography and/or sexual stimulation but neglect paying important bills.

■ You have sex anywhere and with almost anyone you meet.

■ You want to masturbate and/or watch pornography instead of having sex with your partner.

Like any addicted person, sex addicts find their lives spiraling out of control and usually need help in order to recover. If you or someone you love has a sexual addiction, contact Sex Addicts Anonymous at saa-recovery.org or call 800-477-8191.

87vs.31

Percentage of young men compared with women who said they use pornography.

Source: “Generation XXX: Pornography Acceptance and Use Among Emerging Adults,” Journal of Adolescent Research, 2008

realhealthmag.com

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FITNESS

CHAIR LIFTS And other innovative on-the-job workouts Don’t have time for the recommended 30 minutes of daily exercise at home or the gym? Then squeeze it in at the office.

Yes, you can improve your cardiovascular fitness, strength and flexibility—all during a day’s work, says Kara Smith, special programs coordinator for the Loyola Center for Fitness in Illinois.

SMITH RECOMMENDS THESE IN-OFFICE EXERCISES:

Exercise Your Options

I

How to get a total body workout in less than one hour f you’d like to stay fit but never seem to find enough exercise time, then try a total body workout. It’s efficient and effective—plus, it helps you lose or maintain weight and stay in shape, says Pete McCall, a personal trainer certified by the American Council on Exercise (ACE).

Total body workouts challenge all the body’s major muscle groups (legs, core, chest, back, shoulders and arms) in one session. This kind of workout is more effective for people who only have a few days each week to exercise, McCall says.

31.9 1 4 R E A L H E A LTH WIN T E R 2010

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Do one of his 45-minute routines at least three times each week: First work the lower body’s major muscle group: Do three sets (12 repetitions) of the leg press; rest for 45 seconds between each set.

Then work the upper body’s major muscle groups, starting with the larger ones: Do three sets (12 repetitions) each of the shoulder press, back row, chest press, standing cable rotations, biceps curls and triceps extensions; rest for 45 seconds between each set.

For more total body workouts, check out acefitness.org.

—Cristina González

Percent of African Americans who report they engage in no physical exercise at all.

The Centers for Disease Control and Prevention, 2008

realhealthmag.com

DESKSIDE PUSH-UPS: Sit in a wheel-less desk chair and place your hands on its arms. Lift yourself until your bottom clears the chair seat then lower yourself back down. Aim for 15 reps to build arm, shoulder and chest muscles.

WRIST CIRCLES: Hold your arms in front of you and gently move your wrists in a counterclockwise motion. Then make fists and open them as wide as you can. (Great for increasing flexibility.)

“You don’t have to clock 30 grueling minutes on a treadmill—these exercises can be done during a staff break,” Smith says. “Every bit of physical activity [done throughout the day] benefits you.”

–Willette Francis

(WEIGHT/CLOCK) ISTOCKPHOTO.COM/DAMIR SPANIC; (SILHOUETTE) DREAMSTIME.COM/OLEKSANDR KALYNA

NO-ROPE SKIPPING: Pretend you have a jump rope. Swing the invisible rope while jumping on both legs or alternate legs for great cardio benefits.

NUTRITION

What’cha Drinking?

The healthiest beverages to guzzle down

(JUICE) DREAMSTIME.COM/AARON AMAT; (VEGETABLES) DREAMSTIME

15

Don’t believe the hype about everything you drink.

Beverage companies’ health claims are often hard to swallow for a reason. Remember last year’s class-action lawsuit against the Coke-owned makers of vitaminwater? A federal judge ruled that vitaminwater couldn’t be labeled as “healthy” according to Food and Drug Administration definitions.

But some drinks are very nutritious, says Lora Ann Welter, a clinical dietician at Beaufort Memorial Hospital in South Carolina.

Here, she lists the top five, research-backed beverages that legitimately support a healthy lifestyle.

Orange juice Yes, it’s sugary, but this popular citrus drink is loaded with calcium, plus vitamins C and D. (Just drink a little less.)

Kefir This tangy probiotic drink—it’s fermented cow’s milk—enhances digestion, stimulates the immune system and may inhibit bacterial growth.

Red wine Moderate amounts of this

spirited antioxidant drink can boost cardiovascular health. But avoid it if you suffer from high blood pressure or alcohol abuse.

Skim milk Build muscle and strengthen bones with this excellent source of protein, calcium and vitamin D. Water This natural resource provides internal lubrication and cleansing, while properly hydrating the body and maintaining its fluid balance.

What can we say, pour it on.

—Janique Burke

Number of pounds gained in one year from drinking one can of sugar-sweetened soda each day.

Source: American Journal of Clinical Nutrition

BIG DIET DON’T

Eat More, Weigh Less

Sorry, missed meals won’t help you lose weight.

Sound too good to be true? Not really.

To lose weight, you have to eat. That may sound contrary to most diet plans, but the fact is that after four or five hours without food, the body goes into “starvation mode.” If it remains in this state, the body slows down its metabolic process to conserve energy—and burns fewer calories.

The result? You may eventually gain weight.

To keep the metabolism stoked and burning more calories, it’s vital to eat the most important meal of the day— breakfast. Best bets for jump-starting your morning and your metabolism?

Nicolette Keen-Lawrence, MS, RD, CDN, a cardiac transplant dietitian at Montefiore Medical Center in New York, suggests lean protein with carbs, such as egg whites with toast, within one hour of waking up.

Anyone hungry? —Willette Francis

Most diets recommend that we eat less. But while some who follow this calorie-cutting advice do lose weight, many also suffer hunger pangs in the process.

Is there another way? Yes, you can restrict your calories without starving, according to research conducted by the U.S. Department of Agriculture and the Mayo Clinic. It’s simple: Just replace high-calorie foods with their low-calorie counterparts. (Think loading up on steamed veggies instead of french fries.) This allows you to eat bigger portions,

and it raises your satisfaction quotient.

“Extreme calorie cutting doesn’t work,” concurs nutritionist Tracy Noisette of New York City’s Nutrition Solutions. “When people almost starve themselves to lose weight, they are more likely to surrender to unhealthy temptations and fattening meal choices.”

Noisette suggests enjoying meals rich in whole grains, fiber and water to ensure gratification after you’ve eaten. It’s proven.

These low-calorie foods help keep hunger under control.

—JB

AGAINST ALL

ODDS What are the chances that a total stranger might save your life?

Ask Natalie Cole. Her story is unforgettable—talent, fame, addiction, hepatitis and one crucial gift from a woman she never met.

BY KATE FERGUSON PHOTOGRAPH BY JULIE BROTHERS

Like many of the nearly 4 million to 6 million Americans estimated to be infected with hepatitis C, Natalie Cole was unaware she had the virus.

fter she conquered her drug problem, Natalie Cole thought she’d escaped unscathed.

Her heroin habit was history—more than 25 years in the past. Then in February 2008 she needed minor surgery for a hernia and had blood drawn before the operation. Her doctor called with the lab results, and Cole’s past intruded on her present.

“It was a real eye-opener to hear that [my drug use] had come back to kick me in the butt,” the 60-year-old singer says. “I thought that health-wise I had managed to sail through my past drug use without repercussions.”

Cole’s physician didn’t immediately tell her what the problem was. He advised her to see a kidney specialist. The kidney specialist told her she had hepatitis and suggested she see a liver doctor. After a second battery of blood tests, the liver specialist confirmed that Cole had hepatitis C—a serious liver infection.

As Cole’s doctor reeled off the possible ways of contracting the virus—most commonly through direct blood-to-blood contact—she recalled her days as an intravenous drug user. Her doctor asked if she’d shared needles with other heroin addicts.

Cole was candid. She’d done that regularly. The doctor was equally as frank. That might explain her condition, he told her. The hepatitis C virus (HCV) can stay dormant in the body for years.

Like Cole, many people with HCV don’t have symptoms. But others 1 8 RE A L H E A LTH WIN TE R 2010

may be burdened by signs. The most common is fatigue. Others include nausea, fever, night sweats, anxiety, depression, “brain fog” (difficulty thinking or remembering) and muscle, joint, stomach and liver pain.

In general, hepatitis is inflammation of the liver. Of the virus’s five forms—hepatitis A, B, C, D and E— hep B and C are the most chronic and severe. (See sidebar and also visit realhealthmag.com for more.)

The disease is particularly serious and life threatening because the infection affects the liver, the body’s largest internal organ.

An organ that’s crucial to life support, the liver manages more than

It was a real eyeopener to hear my drug use had come back to kick me in the butt.

500 bodily functions to maintain our health. Its job is to filter everything that we eat, drink, smoke and swallow—even what we absorb through our skin. In addition, the liver metabolizes some foods, transforming them into chemicals the body uses for energy, and it also works to detoxify the blood. What’s more the liver stores certain vitamins, such as

A, D, B-9 (folate) and B-12.

The big problem with HCV is that it can cause severe liver damage, leading to a host of other life-threatening health problems.

But the good news is that even when damaged the liver often remains functional. This means that, depending on how impaired the liver is, many people with HCV can lead normal lives.

But Cole didn’t have this option.

By the time she received her HCV diagnosis, her liver was already in an advanced stage of deterioration.

Cole needed strong medicine— quick. “I ended up having to get interferon injections,” she says.

One of the medicines commonly used to treat HCV, the interferon treatment Cole received is a form of chemotherapy. (Today, doctors regard a time-released form of interferon combined with another drug, ribavirin, as the gold standard for HCV treatment.)

“The doctor hoped I would only have to be on it about six or seven months, at the most a year,” Cole explains. “I was hoping to God that I wouldn’t have to be on it for that long because it was just so debilitating.

After I started the treatment, it was only then that I understood how tough going through chemo is.”

Almost immediately after she started treatment, Cole’s body began to strongly react.

“I lost my appetite,” she says.

“Within three weeks, I lost about 20 to 25 pounds.”

Cole was also constantly nauseous, and her energy level hit rock bottom. If that wasn’t enough, her body hurt so much that she didn’t want to move. “I got to the point where walking was very difficult,” she says. “I ended up being in a wheelchair.”

By this time, many people would have surrendered—but not Cole.

Besides the HCV in her blood, she had showbiz stamina in her DNA. (Both Cole’s parents were singers— her dad is the legendary Nat “King”

Cole.) In June 2008, despite undergoing hep C treatment, Cole decided to travel to Japan to keep an entertainment commitment to her fans there.

Although everyone, including her beloved adopted sister, Carol “Cooke” Cole, begged her not to go, a determined Cole packed her bags and went anyway.

Soon Cole realized she had taken on more than she could handle. “It was probably the toughest time working that I’d ever had,” she confesses. “We were supposed to do 14 shows; I managed to do 10. I was in a wheelchair; I had IV tubes strung across my dressing room. It was ridiculous!”

When Cole tells the story in her recently published memoir, Love Brought Me Back: A Journey of Loss and Gain, she describes the horrified looks on the faces of her fans when she was wheeled out onstage.

Cole says she could tell they thought they were looking at a corpse, but she received an amazing response after she sang as well as she ever had.

After returning home, the still ailing Cole continued her hard-driving ways. She launched into a grueling promotional tour for her Grammywinning album Still Unforgettable.

A friend sounded the alarm. While speaking with Cole on the phone, the woman became frightened by the way the singer sounded. She sent a doctor to Cole’s hotel room.

After running tests, the doctor immediately ordered Cole into the hospital. He was worried her kidneys might fail any moment.

Although that didn’t happen right then, doctors said she’d need ongoing dialysis and eventually a transplant to replace her damaged kidneys. The interferon treatments were responsible. “Once I went into kidney failure, that’s the first thing that they stopped,” Cole says.

Today, Cole’s liver condition is stable. Her interferon treatments arrested her hep C infection. And she did have a kidney transplant.

Currently, Cole continues to see both her liver and kidney doctors who closely monitor her health, and she believes people should get tested for the hep C virus. “It’s one of the kinds

of diseases for which people are very rarely screened,” she says. “You can get an HCV infection in many ways: [blood-to-blood contact] from a tattoo, sharing contaminated needles, a partner or a transfusion.”

Besides focusing on hep C and Cole’s other health troubles, the memoir prominently highlights the inspiring story of the kidney donor, Jessica Karina. In fact, if it weren’t for Karina, Cole might not have penned the book.

Without giving away too much of the story, Karina is someone Cole never met. “In these situations, you know very little about the donor and

their families,” Cole says. “This is a very beautiful and sweet story that’s very amazing.” Inspired by the lifesaving generosity of this total stranger, Cole wanted to use the memoir to thank Karina and her family.

“I was not gung ho about the book because there was so much tragedy around my recent health issues,” Cole says. “What prompted me to do it was because of the circumstances surrounding how I got the kidney and the fact that I lost Cooke. Those events just made for a very compelling and powerful story. Everyone who witnessed it said I should write about it.” Everyone was right. ■

Hepatitis ABCs

These viruses can cause cancer or liver disease years after you’re infected. But you can arm and protect yourself today.

Sound the alarm! The United States is suffering a silent epidemic of viral hepatitis. That message was recently delivered to a legislative committee by Howard Koh, MD, MPH, the assistant secretary for health in the Department of Health and Human Services. Several months later, Senator John Kerry (D–Mass.) introduced the Viral Hepatitis and Liver Cancer Control and Prevention Act of 2010. The bill calls for a national strategy to prevent and control hepatitis B and C and is endorsed by more than 100 national, hepatitis-focused organizations.

But what is hepatitis, and why are so many people concerned about it?

Hepatitis is liver inflammation caused by a group of viruses. There are five major types: hepatitis A, B, C, D and E. Of the quintet, A is not a chronic (long-lasting) infection, B and C are chronic conditions, and D and E are uncommon in the United States. In addition, vaccines are available for hep A and B, but not for hep C, D and E. (But the hep B vaccination prevents the development of hep D.) In many cases, hepatitis may not pose a severe health threat. But when it’s chronic, the virus may damage the liver with an increasing amount of scar tissue, resulting in fatigue, mental confusion and even fatal liver disease and liver cancer.

How Hepatitis Is Most Often Spread TYPE

Hep A

Hep B

Hep C

Hep D

Hep E

METHOD OF TRANSMISSION Ingesting fecal matter from person-to-person contact or via contaminated food or drinks (that’s why it’s important to wash your hands after using the bathroom!)

Exchanging bodily fluids during sexual activity, sharing contaminated needles for drug injection, using contaminated medical or dental equipment, and passing the virus from an infected mother to newborn Introducing infected blood into the bloodstream (for example through needle- sharing or using contaminated personal items such as razors) This viral infection is spread like hep B, but hep D is rare in the United States Ingesting fecal matter (usually from contaminated water in countries with poor sanitation; this type is uncommon in the United States)

what “eat ” sensibly means Forget the superfoods hype. Our bodies need a variety of fresh, wholesome foods to function properly.

s there any food that can be consumed in moderation and meet all the body’s nourishment needs? Despite an abundance of catchphrases and claims that seemingly nod to the affirmative—“This superfood can change your life!”—the simple answer is no.

But while some foods do indeed boast more benefits than others, Madison Avenue’s healthy eating hype may prompt people to eat excessive amounts

2 0 R E A L H E A LTH WIN T E R 2010

(POGUE) DUSTIN FENSTERMACHER; (CHILDREN) COURTESY OF ERIC POGUE

BY GERRIE E. SUMMERS

Some of this and some of that. How about a high five for these healthy nutritious foods?

FISH

Why: At least two servings of fish per week will provide low-fat, quality protein, according to the American Heart Association. Cardiologists recommend we eat fish to help prevent heart disease, lower blood pressure and reduce the risk of heart disease and stroke.

over lettuce or mixed salad greens. (Reach for canned salmon that says “wild-caught.” The soft, edible bones are a great source of calcium.)

LEGUMES

Why: These types of veggies include beans, peas and lentils. They are one of Mother Nature’s best sources of soluble fiber. They lower LDL cholesterol levels, slow carbohydrate absorption, control blood glucose levels and reduce cancer risk. Plus, beans are low-fat sources of high-quality protein.

Nutrients: Beans are rich in folic acid, copper, iron, magnesium and vitamin B-6 (the latter helps lower levels of the amino acid homocysteine, which when elevated, puts you at risk of heart disease and stroke). Soybeans provide the same nutrients as other beans but are also a rare plant source of complete protein. They boast nine essential amino acids the body cannot make. Like other legumes, lentils are a good protein source. And peas are an excellent source of B complex, C and A vitamins as well as vision-supportive lutein (an orange-yellow pigment found in fruits and veggies).

Dorfman’s Advice: “Beans are a great source of low glycemic index carbohydrates [they don’t spike blood sugar], protein and fiber, B vitamins and minerals such as iron

There is no such thing as the “perfect” food, but there are delicious, good-for-you eats.

Nutrients: Fish contains riboflavin (B-12), which helps the body metabolize amino acids, fatty acids and carbohydrates; vitamin D, which aids in calcium absorption; and the minerals iodine, magnesium, zinc, iron, calcium, phosphorus and potassium, necessary for maintaining muscle and nerve function and regulating water balance to maintain proper hydration.

Dorfman’s Advice: “[Eating] salmon is a great way to get omega-3 fatty acids—essential fats—which are hard to get in other types of fish. Omega-3s are anti-inflammatory and help the body absorb vitamins A, D, E and K.” Tip: Prepare fish baked, poached, grilled or steamed (not fried). Flavor a salmon fillet with herbs, lemon juice and olive oil and bake for about 10 minutes. Serve with steamed broccoli and wild rice (add a few dried or fresh cranberries to the rice for a little sweetness). Drain and mix with plain low-fat yogurt or mayonnaise, chopped celery, onion, cucumber, green bell peppers, radishes and a little lemon juice, then season with pepper. Serve 2 2 R E A L H E A LTH WIN T E R 2010

and magnesium. An all-around wonderful food.”

Tip: Use beans in soup; add to rice as a side dish with meat or fish. Mix with red onion, green pepper, lemon juice, red wine vinegar, olive oil, dry or fresh herbs and black pepper for a delicious bean salad. Try edamame as a snack straight out of the pod, or boil for three to five minutes and add to stir-fries or soups.

DARK GREEN VEGETABLES

Why? These low-fat, low-calorie, high-protein, high-fiber leafy greens and cruciferous vegetables are powerhouses of vitamins and minerals. The stars of this group are broccoli and kale. Broccoli’s anticancer properties boost DNA repair in cells, reduce the risk of prostate cancer and may also block cancer cell growth. Broccoli also helps prevent heart disease and contains the highest levels of carotenoids (a plant pigment). Kale has cholesterol-lowering benefits (more when steamed than raw) and cardiovascular health benefits, with a significant

(PREVIOUS PAGES) ALL IMAGES DREAMSTIME.COM: (WHEAT) IRINA REDKO; (BERRIES) ANSAR MAHMOOD; (LEGUMES) MANON RINGUETTE; (KALE) ERIC GEVAERT

of said “miracle” food (soy is a perfect example). And this can sometimes do more harm than good.

What’s the best advice? Well, first, cancel your mission to zero in on a single-food nutrient source. The best nutrition plan is to eat a variety of healthful foods.

“There is no such thing as the ‘perfect food,’” says dietician Lisa Dorfman, author of The Reunion Diet. “But there are very nutritious foods. These are what you should include in your diet. And avoid overdosing on any one food or beverage. Moderation is key.”

But all that being said, these five foods come as close to nutrient-dense perfection as we dare to claim. Their health benefits, according to research, play a significant role in treating and preventing various illnesses and disease. In addition to explaining why the five foods are healthful and what nutrients they provide, Dorfman serves up informative culinary tips about how to cook them. It’s our idea of a High Five!

amount of omega-3 and double the vitamin K found in other cruciferous vegetables. Kale helps regulate body detoxification and lowers the risk of five cancers (bladder, breast, colon, ovary and prostate) thanks to carotenoids and flavanoids (antioxidants that fight aging).

Nutrients: Iron, calcium, potassium and magnesium, vitamins A, C, K and E, several B vitamins and omega-3 fatty acids.

Dorfman’s Advice: “Dark greens are a great source of folic acid, fiber and cancer-fighting phytonutrients, with antiinflammatory effects on joints. They are acceptable on most diet programs—which is unusual.”

Tip: Eat dark green vegetables with a teaspoon of dietary fat, such as olive or canola oil, to help the body absorb their vitamins. Add kale, collard and mustard greens to soups and stir-fries. Add romaine, spinach or arugula to tuna, chicken or turkey wraps. Juice romaine and spinach with cucumber, green apple and lemon juice. Cut kale into thin strips and sprinkle with lemon juice. Steam with chopped garlic for five minutes for additional health benefits.

WHOLE GRAINS

Why? These low-fat, fiber-rich complex carbs still have their nutrient-rich bran, germ and endosperm layers intact. The human body digests whole grains slowly, ensuring no blood sugar and insulin spikes.

Nutrients: Includes B vitamins, protein (contains all nine essential amino acids), phytonutrients, selenium, potassium, magnesium, iron and other minerals.

Dorfman’s Advice: “Choosing whole grains ensures the minerals are not stripped in the refining process. Quinoa is a great gluten-free whole grain protein source.”

Tips: When choosing grains, the word “whole” should be the first item on the ingredient list. Substitute whole wheat for white bread, whole grain bagels for plain, and low-fat bran muffins for pastries. Instead of white rice, opt for kasha, brown rice, wild rice or bulgur. Choose high-fiber cereals (bran flakes, shredded wheat, oatmeal), and use wild rice or barley in soups.

BERRIES

Why? These tiny fruits pack a big nutritional punch.

They’re chock-full of antioxidants to combat cell damage caused by free radicals and to protect against a variety of illnesses, such as macular degeneration, colon and ovarian cancer and oxidative stress. In addition, the colorful fruits may help battle Parkinson’s and Alzheimer’s diseases. Blueberries and raspberries also contain lutein.

Nutrients: Berries contain vitamins A, C and E, folic acid, selenium, calcium, phytonutrients, polyphenols and anthocyanins (compounds that give dark berries their color).

Dorfman’s Advice: “Berries are fiber-rich, and phytonutrients boost their antioxidant potential.”

Tips: Enjoy berries in a variety of ways: Eat them alone, mix them with yogurt and granola, blend them in a smoothie, or sprinkle them on top of cereals and salads.

Sounds perfectly nutritious, don’t you think? ■

Fuel Up! Hands down, most nutritionists agree these are the best food energy sources.

FRUITS & VEGGIES Reach for bananas, strawberries, pineapples, apricots and kiwi to rev up your engines. Eat as stand-alone snacks, or mix fruit into low-fat yogurt, smoothies and shakes. And broccoli, cabbage, spinach, sprouts and asparagus also help kick the body into high gear. Add chopped broccoli and spinach to salads, or enjoy their crunchy floret counterparts, along with asparagus, as snacks with healthy dips. And though sprouts might look wimpy, toss them on sandwiches to boost energy levels.

NUTS & SEEDS Nuts—especially almonds, peanuts, walnuts, Brazil nuts and cashews—are high-energy protein powerhouses. Add them to salads, and use their butters to energize smoothies and spread on apple slices. For seeds: Power up trail mix with sunflower and pumpkin seeds. Sprinkle ground flaxseed on salads.

MEAT & POULTRY Fight fatigue with iron- and protein-rich turkey, chicken, lamb and beef. And mix grilled chicken with veggies and yams for an eclectic and energizing feast.

WHOLE GRAINS Oats, millet, brown rice, whole grain pasta, wheat and barley all sustain energy and keep blood sugar stable.

Rolled-oat cereals and whole-wheat pasta with tomato sauce are pre-workout favorites.

BEANS & LENTILS Beans of all kinds are natural energy boosters. Enjoy a bowl of chili or baked beans as a side dish, or try a bean salad.

DAIRY & EGGS Try these energizing snacks: a hard-boiled egg; fresh fruit and granola in a smoothie or mixed into low-fat yogurt; and cottage or string cheese.

FISH & SEAFOOD Stoke your metabolism with the high-quality protein found in tuna and shellfish. Stir-fry shrimp with broccoli or bok choy. Add baby greens or sprouts to a tuna sandwich.

THE ICE

QUEEN On the small screen, Law & Order: Special Victims Unit star Tamara Tunie is a cool, levelheaded forensic specialist. In real life, she helps young girls in Harlem, New York, build their self-esteem and confidence as part of a laudable community skating program.

or the past decade, actress Tamara Tunie has been best known as the no-nonsense medical examiner Melinda Warner, on NBC’s hit crime drama Law & Order: Special Victims Unit. But what people may not know about the Pennsylvania native is that she is a Tony Award–winning producer for the 2006 musical Spring Awakening and that she sang and danced on Broadway at the beginning of her acting career. She also grew up in a funeral home (her father is a mortician). “I saw dead people,” she quips.

2 4 R E A L H E A LTH WIN T E R 2010

Another little-known fact: She advocates for numerous causes in New York City, such as raising money for HIV/AIDS organizations and speaking in favor of marriage equality for same-sex couples.

But one cause that’s most dear to Tunie is helping strengthen young girls’ sense of self-esteem. She sits as the chair emerita of Figure Skating of Harlem (FSH), a nonprofit that provides girls, ages 6 to 18, who live in Harlem, with academic and leadership training and figure skating opportunities. The

AP IMAGES/NBC PHOTO/VIRGINIA SHERWOOD

By Kellee Terrell

Tamara Tunie takes a tough stance on how the media contribute to young girls’ lack of self-esteem.

goal of the program is to build girls’ self-worth while providing support for their academic achievements and their overall well-being.

“I remember looking for an art and education program for girls in my community [to be part of], and then a business associate introduced me to Sharon Cohen, FSH’s executive director,” Tunie recalls. “She told me about the program’s goals, and I knew that this was something that I wanted to participate in.”

Tunie is clear that FSH is not about training the girls for the Olympics. “Skating is just one of the things we have them doing,” she says. “We are focused on self-esteem

understands that getting involved in extracurricular activities can combat some of those negative factors.

“Because I was an athlete when I was younger, I understand how important these programs are. They helped me maintain my focus, stay on track and put my energies into positive and constructive things,” she says.

When she accomplished something as a student, Tunie recalls, she felt good because she knew her teammates and coaches were depending on her. “So I had to stay out of the mess,” she laughs. “It was also a confidence booster that I took with me into my adulthood and in my career.”

SELFESTEEM BEGINS IN THE HOME. building, education, leadership and preparing these girls to be young adults and contributors to their communities.”

Tunie’s concern for young girls stems from the serious pressures they face, the low self-esteem many suffer and their exposure to inappropriate material, thanks to technology and the media.

As a former student athlete, Tunie 2 6 R E A L H E A LTH WIN T E R 2010

Tunie’s experiences are not rare.

Numerous studies show that young people reap benefits when they participate in extracurricular activities. These positive challenges can keep children safe, protect them from negative and harmful behaviors, help them develop social skills, improve academic performance, build strong supportive relationships with adults other than their

parents, boost morale, improve conflict management skills and even lead to better school attendance.

FSH, which has served more than 1,000 girls, offers numerous programs, such as tutoring, creative writing classes, figure skating history and theory classes and career development. They even have a mentorship program allowing these young ladies to visit the workplaces of professional women. In addition, the girls must sign a contract vowing that they’ll respect each other and maintain good grades. “We want to show the girls what opportunities are out there if they just apply themselves,” Tunie says. “I truly believe these kinds of programs prevent our kids from experiencing teenage pregnancies and getting involved with drugs. We are seeing success. We even have girls going off to college, which makes us feel great!”

Every year, FSH boasts a long waiting list. And Tunie is not hardpressed to recite a variety of reasons for the program’s success: the lack of sports-related programs available for girls, FSH’s uniqueness—even the massive cuts that have plagued the art, music and physical education programs at public schools.

But there’s another reason why FSH and Tunie’s work is so important to the area’s young girls. It’s because crime, poverty, drugs and violence still affect many of them, even as Harlem continues to experience massive gentrification some feel is improving the socioeconomic landscape of the famous New York neighborhood.

“Tamara has been such a tremendous angel to FSH, and her involvement, financially and personally, means the world to our girls,” Cohen says. “She really believes in our mission of transforming the lives of young girls through the artistic discipline of skating and the academic challenges of education.”

But Tunie is more than just a celebrity who donates her name to a community program. Her commitment is real. Despite working long hours on the set of Law & Order, directing films and working on a

feature-length cartoon for black girls, she carves out time to serve on FSH’s board of directors. She also holds fund-raisers in her Harlem home, hosts FSH’s annual Skating with the Stars gala and has treated some of the girls in the career mentorship program to a visit with her on the job.

Of course, Harlem’s young girls are not the only ones who can benefit from role models such as Tunie and programs such as FSH. Black girls everywhere need help. The adverse socioeconomic and public health challenges they face on a daily basis are staggering, according to a number of national studies: a 40 percent high school dropout rate, increased poverty, and rising rates of teenage pregnancies, dating violence, HIV and other sexually transmitted infections (STIs).

What’s more, these girls are also struggling with self-image issues and feelings of inadequacy. Despite popular belief (and the Alicia Keys song), not all black women and girls are invincible superwomen.

Last year, the Dove Self-Esteem Fund, a campaign to raise young people’s self-esteem and body image, conducted a national study that explored these very issues by analyzing online data taken from 1,029 girls between ages 8 and 17.

The findings were eye-opening: 68 percent of teenage African-American girls feel they do not measure up in some way regarding their looks, performance in school and relationships with family and friends; 41 percent reported engaging in negative activities such as disordered eating, cutting, bullying, smoking or drinking when they felt bad about themselves; and 28 percent admitted to talking badly about themselves.

“When you are a woman of color and you are surrounded by images of people who do not look like you—who don’t have your skin tone, your hair texture, your facial structure, your body type, and who represent only a Caucasian view of beauty—you tend to look at your own beauty through that lens, even if it’s unrealistic,” says Jess Weiner,

a best-selling author and the global ambassador for the Dove SelfEsteem Fund.

Tunie always encourages girls to ignore what the media tell them they should be. “I try to teach girls that you don’t have to look like the video girls or fit into the image of the skinny Fifth Avenue blonde woman either.”

Health educator Carla Stokes, PhD, MPH, agrees that the media lens distorts young people’s selfimage. “Media—whether it’s the Internet, television, magazines or music—shape how these girls interpret themselves, their sexuality and how they see others around them,” says Stokes, the founder of Helping Our Teen Girls in Real Life Situations Inc. (HOTGIRLS), a nonprofit for African-American girls.

Stokes suggests that teachers and parents be more mindful of the media images that their children are consuming. But she also stresses that self-esteem building begins in the home.

“Parents need to have conversations with their daughters about how these images make them feel,” she says. Do they make girls feel they have to be overtly sexual to get boys’ attention? Do video images of women make them have a negative perception of their own bodies?

Parental support is crucial in young girls’ development. The same Dove study found that 95 percent of teenage African-American girls with low self-esteem wanted their parents to change their behavior toward them in at least one way, such as understanding them more, listening to them more and spending more time with them.

“I was lucky that I had parents who supported me and listened me,” Tunie recalls of her childhood.

“Not everyone is so lucky.”

At the end of the day, Tunie believes the easiest thing we can do for young girls is to simply celebrate them. “We must teach girls to love themselves for who they are in this moment,” she says. “Constantly remind them they are unique, beautiful, talented and smart in their own individual way.” ■

Lift Every Voice Empower your daughter right now!

You should be the biggest positive influence in your daughter’s life.

Health educator Carla Stokes, PhD, MPH, shares these tips to help build her self-esteem:

COMMUNICATE Parents need to have quality communication with their daughters. Make an effort to listen without judgment, and be supportive and engaged.

PRAISE HER Emphasize her inner beauty instead of always focusing on her outer appearance. It’s important to appreciate what makes your girl special and unique.

And don’t forget that while getting her involved in outside activities is key, it’s also important to encourage her to take on activities that interest her and for which she has aptitude.

WATCH WHAT YOU SAY Both male and female parents should be conscious of what they say about bodies, especially their own. Are you criticizing yourself in front of her, or are you making disparaging comments about a radom woman walking down the street?

DON’T NEGLECT HER SPIRITUAL SIDE Studies show that black girls who participated in church activities reported an improved sense of well-being. Faithbased activities offer girls a chance to build their spirituality. These activities also enable them to focus on issues other than their outward appearance.

For more tips on how to bolster selfesteem go to drcarla.com.

HAIR I AM ( Our hair is intricately entwined with our sense of self.

BY WILLETTE FRANCIS

or many black women, hair is often more than a personal accessory. It can be a powerful yardstick others use to measure who you are inside. “I think for African-American women in particular you have to realize hair texture and skin color are huge factors that are intimately tied to how we see ourselves in the world, how other people perceive us and how that connects with selfesteem and the value we place

(NOT)

Who’s this lady?

The politics of self-esteem dictates that black women are judged by the color of their skin and texture of their hair.

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(FIRST PAGES: PORTRAIT) ISTOCKPHOTO.COM

on ourselves,” says Nicole Coleman, assistant professor of psychology at the University of Houston.

In American society, black women and girls are constantly confronted with the reigning standard of beauty—long, straight hair, fair skin and a Barbie doll–shaped body. The visual onslaught permeates our pop culture as reflected in music videos, television and magazines. But even so, this isn’t where we begin to build our self-esteem based on the kind of hair that we have. That outlook begins with messages we get from the women in our lives during childhood. “The messages [our caretakers] give us about our hair are both explicit and implicit,” Coleman suggests. “It’s delivered to us with looks we get or questions such as, ‘So when are you going to get your hair done?’ or ‘Are you going to wear your hair like that?!’ These kinds of questions certainly confirm black women’s sense of how negatively their hair is perceived, which is then translated into how they [begin to] feel about themselves.”

When black women feel they can’t measure up to the ideals of beautiful hair—as defined by both their caretakers and society—it can become a real mental challenge. This mind-set can even lead women to go to harmful extremes to achieve society’s desired look, Coleman says, sharing a story about a woman she met. The woman relaxed the edges of her hair every day so that it could be as straight as possible. The result? She suffered baldness from chemical relaxer overuse.

Although this anecdote illustrates the physical damage that can occur when African-American women obsess about their hair, unseen emotional scars may take a heavier toll on black women’s self-esteem. “[It] certainly breeds insecurity and can contribute to anxiety,” Coleman continues. “Being preoccupied with your hair and how people see it can really become an obsession, and that can create stress and affect your overall life satisfaction.”

Unfortunately, the damage has been done. Many black women do base their self-esteem and self-image on what people think of their hair or appearance. Although this powerful connection can’t be changed overnight, steps can be taken to break the cycle.

Look at yourself in the mirror each day and gaze within, Coleman suggests. “I think if women can focus more on who they are on the inside rather than how others see them, then they will be happier overall.”

For women who are struggling with self-esteem or self-worth for any reason, mental health services can help. Individual counseling or group counseling is a great place to start. Coleman sugsug gests in particular that women try group counseling with other black women because it connects them with women they can relate to on many levels. The experience keeps women from feeling isolatisolat ed, and it offers them peer support in a group setting.

But the real self-esteem work needs to parbegin during childhood—between par ents and little girls. “Regularly sit down and have an age-appropriate dialogue with your children and tell them that everybody is different, and that black women’s hair texture is one of the aspects of how God made us different,” Coleman suggests. “Really bring it down to a human level and let them know that their differences don’t detract from their value and worth.” ■

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AIM FOR COMPLETE COVERAGE. Use a permanent hair color product that offers 100 percent gray coverage. Cover and blend is the rule when tackling this mission. Stay close to your original color for the most natural-looking results.

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COMMIT TO CARING FOR YOUR COLORTREATED HAIR. No shortcuts, please. Get regular touch-ups and deep conditioning treatments before tinting your tresses.

CONDITION, CONDITION, CONDITION. Hair coloring can dry out your hair. Use moisturizing shampoos and conditioners to keep your mane looking healthy, supple and vibrant.

W IN TER 2010 RE A L H E A LTH 3 1

THOUGHTS

Let Healing Begin After Garry Jones sought treatment for depression, he decided silence was not an option.

To break out of a rut and transform your life, cultivate positive affirmations amid the turmoil.

W

hen down periods dampen your life, you may find it difficult to cope. But don’t feel sad, afraid or hopeless.

Marshal your confidence and make an effort to push through to the better times that (you know) lie ahead.

Yes, this is often easier said than done. But with help from loved ones, or a mental health professional, you can get the support you need to make it through. Another key to staying positive amid a sea of negativity is to stop worrying and grumbling. Complaints only make you feel worse and add to the toxic atmosphere.

Instead, use positive affirmations to develop a more upbeat attitude about any unpleasantness you’re experiencing. For example, if you don’t like your job or are among the unemployed, try reassuring yourself with these declarations: “My next job will be better than the last” or “I’ll feel even more fulfilled in a more responsible position.”

You’ll gain a new, more helpful outlook—and the confidence that you can face any adversities the future may have in store.

In other words, you’ll have overcome.

—Willette Francis 3 2 R E A L H E A LTH WIN T E R 2010

I

realhealthmag.com

THE EXPERT SAYS For the almost 15 million adults living with depression, it can be a daily struggle to stay in touch with reality. Here Jon G. Allen, PhD, senior staff psychologist at the Menninger clinic in Houston and author of Coping With Depression, explains the basics of this disorder.

WHAT IS DEPRESSION? Depression is more than just feeling sad; it’s a serious psychiatric disorder that impairs your ability to function.

stressful life events that cause psychological problems. These problems may affect someone’s brain function and also influence mood.

WHAT ARE THE MAIN SYMPTOMS? Weight loss or gain, a diminished interest in pleasure, insomnia, loss of energy, feelings of worthlessness or guilt, and thoughts of suicide.

ARE CERTAIN GROUPS AT HIGHER RISK? Depression knows no cultural boundaries, but women are twice as likely to suffer from depression as men.

WHAT CAUSES IT? Genetics, biochemical changes and certain

HOW IS IT DIAGNOSED? By simply visiting a doctor and getting an evaluation.

—Cristina González

DREAMSTIME.COM/JASON STITT

You Shall Overcome

As a retired lieutenant from the Federal Bureau of Prisons, I cannot find words to describe what I witnessed while working in six institutions. But my depression didn’t start then. My pain started 40 years earlier, before I knew what depression was.

In college, I started drinking and smoking reefer to ease the pain. But marijuana made me paranoid, so I stopped. Then, I got married and bottled my pain.

On the job, I exposed corruption in the prison system. Retaliations followed and worsened my depression. I thought about suicide, then saw my children’s faces and finally entered therapy.

One day, I saw a woman on TV talking about her son’s suicide. She’d discovered he was suffering from depression only after she read his suicide note. He didn’t show any signs, she said—just like me.

Although I was unable to contact this lady, a woman at the TV station I called invited me to discuss depression on her show. At first, I was reluctant. I worried that the prison staff and inmates might see me and think I was weak. But I went on the show anyway and shared my story.

Today, I’m still in pain but remain enrolled in therapy. And I take life one day at a time.

—As told to Willette Francis

READER SURVEY

SPEAK YOUR MIND!

(And Win Free Stuff)

For many people, the end of the year is a time of reflection, an opportunity to take stock of goals achieved and those still unmet. With an eye to your physical and mental health, we want to know all about your year. How did 2010 treat you? Tell us by filling in the survey below. To say thank you, we’ll select two readers at random whose surveys we receive and send them a deluxe fitness DVD (suggested retail price about $25), like the one pictured left.

Win this year-end gift now!

To enter our drawing, take the survey at realhealthmag.com/survey or fill out this form and mail it to Real Health, c/o Smart + Strong, 462 Seventh Avenue, 19th Floor, New York, NY 10018, or fax it to 212.675.8505. For official contest rules, visit realhealthmag.com/survey/rules.

1. Name:_______________________________________________________ 2. Organization (if you represent one):______________________ 3. Street address:_____________________________________________ 4. City & state:_________________________________________________ 5. Zip code:____________________________________________________ 6. E-mail:_______________________________________________________ 7. Phone:_____________________________________________________

14. Do you have Internet access? ❑ Yes ❑ No

15. If you made 2010 resolutions, how many did you keep? (Check all that apply.) ❑ One ❑ Two ❑ Three or more

8. What year were you born? __________

❑ None

9. What is your gender?

16. What was your greatest achievement this year?

❑ Female

❑ Weight loss

❑ Male

❑ Financial stability

❑ Transgender

❑ Met my soul mate

❑ Other

❑ Good health ❑ Other: __________________________________

10. What is your annual household income? ❑ $15,000–$34,999

17. Did you experience any illness or injury during the year?

❑ $35,000–$49,999

❑ Yes ❑ No

❑ Under $15,000

❑ $50,000–$74,999 ❑ $75,000–$99,999 ❑ $100,000 and over

18. Compared with last year at this same time, are you happier? ❑ Yes ❑ No ❑ Same

11. What is the highest level of education attained? ❑ High school graduate

19. If you could pick only one thing, what kept you sane this year?

❑ Some college

❑ My friends

❑ Some high school

❑ Bachelor’s degree or higher

❑ My family ❑ My faith

12. What is your ethnicity?

❑ Other: __________________________________

❑ American Indian or Alaska Native ❑ Asian

20. Compared with last year at this time, are you healthier?

❑ Black or African American

❑ Yes ❑ No ❑ Same

❑ Arab or Middle Eastern

❑ Hispanic or Latino ❑ Native Hawaiian or other Pacific Islander

21. Did you get a flu shot this year?

❑ White

❑ Yes ❑ No

❑ Other

13. Where do you get Real Health?

22. What was the most valuable lesson you learned this year?

❑ I’m a subscriber

❑ Don’t procrastinate

❑ My doctor’s office

❑ Friends can’t be trusted

❑ My church

❑ Things can always be worse

❑ A community or college organization

❑ It’s important to save for a rainy day

❑ It was mailed to my home or office

❑ There’s a lot of good in the world

❑ Other: _______________________________

❑ Other: ________________________________ Winter 2010

Do what’s better for your mouth.

STOP BRUSHING WITH REGULAR TOOTHPASTE AFTER 12 HRS.

START Regular Toothpaste

FIGHTING GERMS FOR

12 HOURS AFTER 12 HRS.

Colgate Total® fights germs for 12 hours.

Regular toothpastes don’t. * Dramatization illustrating reduction of plaque bacteria 12 hours after brushing with Colgate Total® vs. regular fluoride toothpaste. © 2010 Colgate-Palmolive Company