FALL 2026
Pelvic floor during and after pregnancy: What to expect Seasonal flu shot especially important, and safe, during pregnancy
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WOMEN’S HEALTH What to know about cervical cancer
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Why women need to take stroke seriously
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Pelvic floor during and after pregnancy: What to expect
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Ovarian cancer: Get the facts
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CARDIOVASCULAR HEALTH How does blood pressure work?
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Stay focused on lowering LDL cholesterol rather than raising HDL
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SEASONAL HEALTH Try this: Winter skin care
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6 ways to eat more fiber during the holidays
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Seasonal flu shot especially important, and safe, during pregnancy
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Health care | Fall 2026
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WHAT TO KNOW ABOUT CERVICAL CANCER Kristina Butler, M.D., Mayo Foundation for Medical Education and Research, Premium Health News Service
DEAR MAYO CLINIC:
My mom had a pap smear recently, and the results came back as abnormal. After further testing, we were shocked when she was diagnosed with cervical cancer. She didn’t have any symptoms. Now, her healthcare team is discussing surgery and medications. What should I know about her illness? As her daughter, should I be worried about myself? Most importantly, how can I support her during treatment?
ANSWER:
I commend you for finding ways to support your mom through her cervical cancer diagnosis. Gathering reliable information about her illness and treatment is a great start. Part of the reproductive system, the cervix connects the vagina to the uterus, also known as the womb. By collecting cervical cells — called the Pap smear after the scientist who pioneered the screening test in the mid-1900s — cancer can be detected even at an early stage. While cervical cancer may cause symptoms of bleeding or pain, it often does not cause any symptoms, especially in early stages. That’s why Pap smears typically are recommended every three years for women ages 21 to 65. For women who are 30 and up, Pap smears may be recommended every five years, combined with testing for HPV infection. Pelvic examination with assessment of the cervix and other gynecologic structures, such as the vagina, vulva, urethra, anus, uterus and ovaries, can be easily performed in years when a Pap smear is not due.
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HPV is the most common cause of cervical cancer. It is a frequent viral infection transmitted sexually through skin-to-skin contact. To help protect from cancer in the future, an HPV vaccine is available for males and females starting at ages 9 to 11. The vaccine is approved by the Food and Drug Administration (FDA) for people ages 9 to 45. Treatment for cervical cancer will depend on many factors. For early-stage cervical cancer, a surgery called a total hysterectomy to remove the cervix and uterus may be considered. A hysterectomy may be performed through a cut in the lower part of the belly. Or a hysterectomy can be done through a cut in the vagina. Minimally invasive procedures, such as with robotic-assisted or laparoscopic surgery using long, thin surgical instruments passed through small cuts in the belly also are options. However, removing the uterus means pregnancy no longer is possible. Some surgical procedures, such as a trachelectomy — cervix removal — can preserve the uterus and fertility options. For cervical cancer that has advanced but has not spread to other parts of the body, chemotherapy and radiation — delivered internally, externally or both — are typically recommended. Medications are available for advanced cervical cancer that is continuing, keeps coming back or has spread. Targeted therapy called bevacizumab often is used in combination with other medicines. For patients who test positive for PD-L1 — a type of protein that stops the immune system from attacking cancer — an immunotherapy called pembrolizumab also may be used. So-called “second-line treatments,” such as tisotumab vedotin-tftv, given after earlier treatments have been unsuccessful, also are available and showing improved overall response rate.
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While all treatments have benefits and risks, these treatments hold promise for enhanced long-term outcomes for patients with advanced and recurrent cervical cancer. No matter what treatment plan your mom pursues with her care team, you can help in a variety of ways, such as doing household chores like cooking or cleaning. Your mom may appreciate you going to her medical appointments to ask questions, take notes or be another person to process all the information. Don’t forget prevention measures to reduce your risk of developing cervical cancer: • • • •
Ask your healthcare team about an appropriate Pap test routine for you depending on your age and individual factors. Consider the HPV vaccine. The HPV vaccine is approved by the FDA to age 45. Are you up to date on your vaccines? If you are sexually active, practice safe sex by using condoms and limiting sexual partners. If you smoke, work hard to quit. Your healthcare team can point you to a variety of resources to stop tobacco use. Research shows women who smoke are twice as likely to get cervical cancer.
Kristina Butler, M.D., Obstetrics and Gynecology, Mayo Clinic, Phoenix Mayo Clinic Q & A is an educational resource and doesn’t replace regular medical care. This Mayo Clinic Q&A represents inquiries this healthcare expert has received from patients. For more information, visit www.mayoclinic.org.
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Health care | Fall 2026
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WHY WOMEN NEED TO TAKE STROKE SERIOUSLY
Bayan Moustafa, D.O., Mayo Foundation for Medical Education and Research, Premium Health News Service
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DEAR MAYO CLINIC:
I read recently that stroke is one of the leading causes of death for women. I thought strokes mostly were a problem for men. Can you fill me in?
ANSWER:
Ladies, the statistics are not in our favor. We need to take the risk of stroke seriously. You’re not alone in your understanding of stroke risks for women. Many women underestimate their risk of stroke and believe that it mainly affects men. In reality, stroke is the fourth-leading cause of death for women. In the U.S. in 2021, 57% of stroke deaths occurred in women. According to the Centers for Disease Control and Prevention, about 1 in 5 women between the ages of 55 and 75 will have a stroke. Each year, stroke kills nearly twice as many women as breast cancer. WOMEN’S RISK FACTORS FOR STROKE There are a few reasons why women are at higher risk. High blood pressure is a major factor, and nearly 40% of women have elevated blood pressure or are taking medication to keep their blood pressure under control. Women also have a higher risk of stroke than men for reasons related to reproduction. Oral contraceptives, pregnancy and postmenopausal hormone therapy can all elevate women’s stroke risk. Women who develop preeclampsia, eclampsia or gestational diabetes while pregnant have a greater chance of stroke. Depression is also a risk factor, and women have higher rates of this condition than men. Stroke risk increases with age. Women, on average, live longer than men, so they’re at greater risk over their lifetimes.
Health care | Fall 2026
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Some groups of women, including African American and Hispanic women, are at even greater risk due to higher rates of high blood pressure, obesity and diabetes. For African American women, sickle cell disease is also a factor. Other factors that raise a person’s stroke risk include heart disease, including abnormal heart rhythms like atrial fibrillation; smoking or tobacco use; and physical inactivity. KNOW THE WARNING SIGNS It’s important to learn the many warning signs of a stroke and seek emergency medical care immediately after the first symptoms appear. Stroke symptoms appear suddenly. Here’s a saying and acronym to make recognizing and acting on these symptoms easy: “THINK FAST” FACE: Ask the person to smile. Does one side of their face droop? ARMS: Ask the person to lift up both arms. Does one arm drift downward, or is one arm unable to rise? SPEECH: Ask the person to repeat a simple or common phrase. Is their speech slurred or strange sounding? TIME: If you notice any of these signs, call 911 immediately. Some treatment options need to be used in the first 4½ hours after a stroke, so it’s essential to get help quickly. Other stroke symptoms may include: • • • •
Sudden onset of numbness, especially on one side of the body. Trouble with vision, such as double, partial or complete vision loss in one or both eyes. Dizziness and trouble walking. Severe headache.
You may be tempted to downplay symptoms and not want to go to the hospital. This feeling is normal, but it’s not a good idea. When care is delayed for someone having a stroke, the person’s brain is deprived of blood, oxygen and nutrients. Within minutes, brain cells start
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to die. Emergency medical care by experts trained in the diagnosis and treatment of stroke is necessary to preserve brain cells and, in the most serious cases, prevent death. Time is critical with a stroke, so it’s usually best to call 911. Don’t try to drive yourself or ask someone to drive you to the emergency department. EMTs and ambulances have monitoring devices, medications and direct-to-the-emergency-department communications that can save your life and reduce damage. STROKE TREATMENT More treatment options are available if you get to the emergency department quickly. Sometimes, medications can be administered through an IV to break up blood clots. The sooner the medications are given, the better. The medications are only effective if delivered within 4 1/2 hours from the start of symptoms. This time frame may be only three hours for specific patient populations, so it’s critical to seek medical evaluation as soon as symptoms start. If a blood clot causes a stroke in a large artery, endovascular therapy may be necessary to remove the clot with a stent retriever. This intervention is also time sensitive. Talk with your health care team about your own risk for stroke. Learn how to spot a stroke using FAST, and encourage people in your life to do so as well. —Bayan Moustafa, D.O., Neurology, Mayo Clinic Health System, Eau Claire, Wisconsin Mayo Clinic Q & A is an educational resource and doesn’t replace regular medical care. This Mayo Clinic Q&A represents inquiries this healthcare expert has received from patients. For more information, visit www.mayoclinic.org.
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PELVIC FLOOR DURING AND AFTER PREGNANCY:
WHAT TO EXPECT
Tarek Khalife, M.D., Mayo Foundation for Medical Education and Research, Premium Health News Service
DEAR MAYO CLINIC:
I’m pregnant with my first child, and I’ve heard a lot about pelvic floor changes during pregnancy and childbirth. I’m a bit worried and curious about what to expect. Can you explain these changes and offer advice on preparing for a healthy pelvic floor after pregnancy?
ANSWER:
Pregnancy and childbirth are transformative experiences for a woman’s body, affecting it in many ways. One of the areas that may be affected is the pelvic floor, which is the diaphragm of the pelvis. These muscles support the uterus, bladder, large intestine and rectum. Often, these muscles are affected by pregnancy and childbirth, altering some of their vital functions. These can include fecal and urinary continence mechanisms and support of the vaginal walls and uterus. Less support can lead to prolapse, when organs shift within the pelvis. Trauma to the pelvic floor muscles and nerves also may result in pelvic pain symptoms occurring with or without sexual intercourse. Here are some of the factors that can affect your pelvic floor during pregnancy and childbirth and how they can lead to pelvic floor disorders in the future: PHYSICAL CHANGES. About 50% of pregnant women experience symptoms of pelvic floor disorders even before childbirth. During pregnancy, women tend to gain weight — not just the baby’s weight but also weight from the placenta, increased blood volume and an enlarged uterus. The extra weight increases strain on the pelvic floor muscles, resulting in an increased risk of urinary incontinence.
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Constipation is common during pregnancy, especially in the third trimester. The weight of the growing uterus and hormone changes can affect digestion, leading to infrequent or difficult passing of stools. Any related straining and stress can weaken pelvic floor muscles and nerves further. HORMONAL CHANGES. The body also undergoes significant hormonal changes during pregnancy that affect pelvic floor health. The placenta secretes the hormone relaxin to increase the flexibility of ligaments in the pelvis and soften the cervix. These changes are good because they prepare the body for birth. However, this can loosen the connection between the pelvis bones and lead to increased flexibility and instability . MEDICAL AND OCCUPATIONAL HISTORY. Some women are more susceptible to pelvic floor disorders, and this risk increases with pregnancy. Women with a history of chronic constipation, connective tissue disorders or smoking are at increased risk. Women who are obese or have a history of repeated heavy lifting, either at work or through weight training exercises, also can be at increased risk. Labor and delivery are considered risk factors for pelvic floor disorders. Vaginal delivery, in particular, is regarded as the most significant risk factor. During childbirth, the pelvic floor muscles undergo tremendous stress, especially during the second
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stage of labor, when patients are actively pushing. This risk is increased with operative deliveries using vacuum or forceps. Labor before a cesarean section delivery also increases a woman’s risk for pelvic floor disorders. Some women’s pelvic floors are more resilient and able to recover quickly, while others may be more prone to lasting issues. Studies show that the more vaginal deliveries a woman has, the more likely she is to experience pelvic floor dysfunction. It’s important to remember that pelvic floor disorders are not a forgone conclusion during pregnancy. Just as pregnant women take prenatal vitamins and avoid alcohol to lower the risks of some congenital conditions, they can take steps to reduce the risk of pelvic floor disorders. Regular exercise and eating a healthy diet are good for your baby and good for your pelvic floor as well. I also recommend that you consider attending birthing classes before childbirth. Often, these include stretching and breathing exercises to help coordinate the diaphragm and pelvic floor muscles during delivery. Pregnancy yoga and perineal massage can help prepare your pelvic floor by improving the flexibility and stretchability of tissues to limit your risk of perineal injuries at delivery.
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When done correctly, Kegel exercises strengthen the pelvic floor muscles. About 40% of people don’t perform a Kegel correctly the first time. A physical therapist can help you identify the correct muscles if you are uncertain or have questions. Finally, talk with your OB-GYN and healthcare team about your concerns. They can recommend stretches and classes to prepare your pelvic floor for childbirth. — Tarek Khalife, M.D., Obstetrics and Gynecology, Mayo Clinic Health System, Mankato and New Prague, Minnesota Mayo Clinic Q & A is an educational resource and doesn’t replace regular medical care. This Mayo Clinic Q&A represents inquiries this healthcare expert has received from patients. For more information, visit www.mayoclinic.org.
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OVARIAN CANCER: GET THE FACTS
Sandeep Basu, M.D., Mayo Foundation for Medical Education and Research, Premium Health News Service
DEAR MAYO CLINIC: ANSWER:
I’ve heard that ovarian cancer is hard to detect. Can you tell me more about the symptoms and if there are any screenings?
Ovarian cancer is relatively rare. However, it’s often fatal in later stages of the disease. The cancer begins in the ovaries and spreads to the abdomen and pelvis if it isn’t diagnosed and treated early. It primarily affects older women; about half of those diagnosed are age 63 or older. It’s also more prevalent among white women than Black women. Here are some statistics for ovarian cancer: • • • •
In the U.S., it’s the second-most common female reproductive organ cancer after uterine cancer. The risk of getting ovarian cancer in a woman’s lifetime is about 1 in 91. Nearly 21,000 women are diagnosed with ovarian cancer every year. Roughly 250 women die of this disease each week. Even though uterine cancer is three times more common, the number of women dying from ovarian cancer each year is almost the same, around 13,000 deaths. This death rate points to the difficulty of detecting this aggressive form of cancer.
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RECOGNIZING THE SYMPTOMS As with any cancer, early diagnosis of ovarian cancer can improve the chances of successful treatment. If you are experiencing these symptoms, see your healthcare clinician: • • • • • •
Quickly feeling full when eating Abdominal bloating or swelling Weight loss Frequent need to urinate Changes in bowel habits Discomfort in the pelvic area
UNDERSTANDING THE RISK FACTORS A family history of ovarian cancer and personal factors can increase your risk of ovarian cancer, including: • • • • •
Obesity Genetics/family history Hormone replacement therapy Personal history of cancer or endometriosis Increasing age or reproductive history and infertility
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Some factors that can decrease your risk include: • • • •
Oral contraceptive use Pregnancy and breastfeeding Removal of the ovaries and fallopian tubes Hysterectomy or tubal ligation
DETECTING OVARIAN CANCER There are well-established screening programs for certain cancers, such as breast, colon and cervical cancer, which can help prevent these cancers from developing. Screening also can detect cancer at an early stage when treatments are more effective. Unfortunately, there isn’t a universal screening program for ovarian cancer. That’s because testing options often lead to high rates of false-positive and false-negative results. Also, ovarian cancer doesn’t predictably develop precancerous cells, and it’s difficult to get tissue samples from the ovaries. The most relevant tools for finding ovarian cancer are imaging tests, such as an ultrasound, and tumor markers that can be found in the blood, such as cancer antigen 125, or CA 125. Ultrasounds are good at identifying cysts or other masses growing on the ovaries. The challenging part is that these masses are quite common, and most are not cancers. While the appearance of an ovarian mass can give some clues about its chance of being cancerous, with an ultrasound, it’s often difficult to tell the difference between masses that are cancers and those that aren’t.
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WHAT IS CA 125? CA 125 is a protein in the blood that can be elevated when ovarian cancers are present. However, it also can be elevated with other conditions, such as menstruation, uterine fibroids and endometriosis, leading to falsepositive results. Early detection is the goal of a good screening program, but CA 125 can miss a significant number of early-stage ovarian cancers. Ultrasounds and CA 125 tests have been evaluated as potential screening tools. Unfortunately, they can’t consistently detect ovarian cancer early enough to improve patient outcomes. They also have a high falsepositive result rate, increasing the risk of unnecessary stress, anxiety and surgery. However, in some situations, these tests are used to screen for ovarian cancer, such as in patients with genetic mutations that put them at high risk for cancer and in patients previously treated for ovarian cancer. — Sandeep Basu, M.D., Breast Cancer Care, Hematology and Oncology, Mayo Clinic Health System, Eau Claire, Wisconsin Mayo Clinic Q & A is an educational resource and doesn’t replace regular medical care. This Mayo Clinic Q&A represents inquiries this healthcare expert has received from patients. For more information, visit www.mayoclinic.org.
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HOW DOES BLOOD PRESSURE WORK? Staff, Harvard Health Letter, Premium Health News Service
Q: A:
What is the role of blood pressure, how does it work, and what are the factors that affect it?
A simple way to understand it might be imagining this scenario: You’re in your back yard, holding a hose. When you turn on the water, it shoots through the hose and out the nozzle. The water is moving because it’s under pressure. Similarly, when your heart beats it creates pressure that enables your blood to “water” your body with the nutrients that are in your blood. Three things affect the amount of pressure that pushes blood through your body: how forcefully the heart pumps, how much blood there is and how narrow the smallest blood vessels are. That last one may need some explanation. When you’re watering plants, and you want the stream of water
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to go farther, what do you do? You make the nozzle smaller. Narrowing the opening through which the water flows increases the pressure, and the water then is able to reach the distant flowerbed. What affects how hard the heart pumps? Several body hormones, particularly epinephrine and norepinephrine, “whip” the heart to beat faster and harder. These hormones are made by your adrenal glands, located just on top of your kidneys. Exercising and fear cause increases in these two hormones, which is good: your heart needs to work harder when you exercise, or when you may need to run away from something frightening. However, chronic anxiety and stress also increase these hormones, and that’s not good. During a stressful day, no good purpose is served by your heart beating faster and harder, and by your blood pressure going up. Some uncommon diseases — not just chronic anxiety and stress — also can raise levels of these hormones. What affects how much blood you have? Blood is part water. Therefore, the amount of fluid you
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drink and the amount you lose through sweating and urination affect how much fluid there is in your blood. Blood also is part salt. Salty foods, and salt added to your foods, can increase the fluid in your blood. That’s why people with high blood pressure are urged to go light on salt, and often given diuretic drugs to help their kidneys eliminate excess fluid and salt. What affects how narrow your small blood vessels, or arterioles, are? These blood vessels have circles of muscle in their walls that can clamp down and narrow the vessels. The same hormones — epinephrine and norepinephrine — that whip your heart to beat faster and harder also cause the blood vessels to clamp down, raising blood pressure. In other words, blood pressure is influenced by many factors. Maintaining normal blood pressure — one that can rise and fall as your body needs it — is essential for good health.
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STAY FOCUSED ON
LOWERING LDL CHOLESTEROL RATHER THAN RAISING HDL
Howard LeWine, M.D.. Harvard Health Publishing, The Medicine Cabinet
Q:
How much does a normal or high HDL cholesterol protect you from the adverse health effects of a high LDL cholesterol?
A:
Lowering elevated levels of low-density lipoprotein (LDL), or “bad” cholesterol, is well established as one of the most important ways to prevent and treat heart disease. Low-density lipoprotein (LDL) is considered bad for a good reason. Excess amounts can accumulate in artery walls and cause fatty plaque buildup. If the buildup becomes excessive or a plaque ruptures it can block blood flow to the heart or brain, triggering a heart attack or stroke.
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Another kind of cholesterol — high-density lipoprotein (HDL) — is commonly referred to as “good” cholesterol. But this moniker is misleading. Your HDL level is primarily determined by genetics. A low HDL level of less than 40 mg/dL for men or 50 mg/dL for women means you are more likely to develop cardiovascular disease. But a normal or high HDL level does not necessarily mean you are protected. Some HDL particles gather excess cholesterol from the bloodstream and artery walls and deliver it to the liver, where it’s broken down into harmless particles. In this way, HDL is considered “good.” But the HDL story is not that simple. HDL is not a single particle, but a family of different particles that come in various shapes and sizes. They can be small, medium or large. Some types are spherical, while others are dough-nut-shaped. This variety means not all HDL acts the same way. Some particles are great at grabbing excess cholesterol, while others are not. Some even transfer cholesterol the wrong way — away from the liver and into the bloodstream.
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There is still much we don’t know or understand about HDL. But the evidence is clear that managing LDL levels is what matters most. Whereas lowering LDL can significantly reduce the risk of heart attack, stroke and other cardiovascular problems, raising HDL levels does not have the same positive effects. For instance, the results of studies involving a type of medicine that can raise HDL levels, called cholesteryl ester transfer protein (CETP) inhibitors, have been disappointing. Although these drugs can increase HDL levels — by as much as 60% in some cases — the higher HDL levels did not lead to a lower risk for heart attacks, strokes or clogged arteries. This is cited as a major reason why the FDA has not approved any of these drugs. Don’t be surprised if you still hear HDL called the “good” cholesterol, as our understanding of HDL’s complexity remains a work in progress. But don’t get distracted by your HDL number; instead stay focused on your goal LDL level based on all your cardiovascular risk factors. Managing LDL levels is the top priority. Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.
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TRY THIS:
WINTER SKIN CARE Matthew Solan, Harvard Men’s Health Watch, Premium Health News Service
Here’s how to prevent and treat dry skin during the cold-weather months. Use a humidifier to pump moisture into dry indoor air. Set it to around 60%, a level that should be sufficient to replenish moisture in the skin. Limit yourself to one 5- to 10-minute bath or shower daily. Bathing for too long will strip away some of the skin’s protective oil layer and cause moisture loss. Always use lukewarm and not hot water. Avoid scented soaps, which can also remove the skin’s natural oils. Choose an unscented soap that contains glycerin, or opt for a soapfree cleanser.
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Don’t scrub your skin with bath sponges, scrub brushes or rough washcloths. Pat your skin dry with a soft towel both after bathing and washing your hands. Immediately apply moisturizer to your skin. Moisturizers help fill the spaces between skin cells and seal in moisture. Look for products that contain at least one of the following ingredients: glycerin, urea, pyroglutamic acid, sorbitol, lactic acid, lactate salts or alpha hydroxy acids. Always cover exposed skin when outdoors. If you can’t wear protective clothing, apply a moisturizing sunscreen with an SPF of 30 or higher. At bedtime, coat cracked skin on your hands and feet with a thick layer of moisturizer or petroleum jelly and cover with cotton gloves or socks while you sleep. Matthew Solan is the executive editor of Harvard Men’s Health Watch.
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WAYS TO EAT MORE FIBER DURING THE HOLIDAYS Victoria Whittington, RDN, EatingWell.com, Premium Health News Service
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How we eat during the holidays can be much different than what we normally eat the rest of the year. One big change during this season? Your fiber intake may take a hit. Consuming enough dietary fiber daily supports your health in many ways, so check out these dietitian-approved tips for eating more fiber during the holiday season.
1. START EARLY IN THE DAY Julia Stevens, M.P.H., RDN, registered dietitian with Active Nutrition, recommends starting the day with a fiber-packed breakfast. “It’s hard to catch up on your fiber later in the day,” she says. “I recommend adding a tablespoon of chia seeds to breakfast. Mix it into your oatmeal, overnight oats, yogurt or a smoothie to boost that fiber and get you started on the right foot,” Stevens adds. One tablespoon of chia seeds has about 5 grams of fiber. Another idea for a fiber-packed breakfast is to make an egg and veggie bake. “It is easy to make and can be prepared ahead so that your breakfast is ready to be warmed up in the microwave throughout the week. Add a variety of vegetables to get in more fiber,” says Kate Reeder, M.C.N., RDN, a registered dietitian.
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2. USE FRUITS IN DESSERTS Fruit is a sweet treat and an excellent source of fiber. That’s why Lilian Shepherd, RD, CDCES, a registered dietitian and certified diabetes educator, suggests choosing dessert recipes packed with fruit. Berries with whipped cream are one dessert she recommends. You can also make a berry mix to serve over Greek yogurt.
3. ADD ALMONDS
“One strategy to increase fiber intake during the holidays is by preparing dishes with almonds,” says Patricia Kolesa, M.S., RDN, founder of Dietitian Dish. “Almonds can be easily added as part of a charcuterie board or cheese plate as an appetizer, blended into an almond butter spread, or used in desserts like cookies and clusters,” Kolesa adds. A 1-ounce serving of almonds has about 3.5 grams of fiber.
4. GIVE VEGETABLES A STARRING ROLE Instead of having vegetable sides for your holiday spread, make them the star of the show. Shepherd suggests combining roasted Brussels sprouts and squash. Roast all of the vegetables in the same pan, which makes it easy to prepare and perfect for holiday buffet tables and potlucks. Cranberries can add a sweet-tart edge.
5. EAT MORE CHILIS, STEWS AND SOUPS Enjoying more soups, stews and chilis during the holiday season is a simple and satisfying way to boost your fiber intake. “Packed with fiber-rich ingredients like beans, lentils, vegetables and whole grains, these hearty dishes help you stay fuller longer while supporting digestive health,” says Shepherd.
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6. EAT CONSISTENTLY THROUGHOUT THE DAY Many people skip meals and snacks around the holidays to “save up” for the meals they’ll enjoy later, but this can be more harmful than helpful. Not only does it interfere with your fiber intake, but meal skipping may also lead to headaches, irritability and overeating later in the day. Eat regularly and prioritize fiber and protein as usual. Eating consistently while consciously choosing high-fiber foods will help you eat more fiber during the holidays. It also keeps blood sugar levels stable and increases feelings of fullness, helping to prevent overeating later in the day. EatingWell is a magazine and website devoted to healthy eating as a way of life. Online at www.eatingwell.com.
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SEASONAL FLU SHOT
ESPECIALLY IMPORTANT, AND SAFE, DURING PREGNANCY
Q:
I can’t decide what to do about getting flu shots. I just found out that I am six weeks pregnant. What are your thoughts?
A:
Pregnant women and those who expect to become pregnant are being urged to get flu shots. But that’s not always a simple decision for a woman once she knows she is pregnant. For most, protecting the health of the fetus is their No. 1 concern. This means many of them won’t take a certain medicine or have a medical procedure unless they know that it is absolutely safe for the baby. The U.S. Centers for Disease Control and Prevention (CDC) and The American College of Obstetricians and Gynecologists (ACOG) say that pregnant women should get the seasonal flu vaccine. In fact, they are on the priority list to get the vaccine. Pregnancy puts women at increased risk of getting serious health problems if they get the flu. In any given year, there is always the chance that the new flu strain will cause more than the usual cases of severe symptoms and also be more easily transmitted from person to person. That can happen when pregnant women have not been exposed to the current circulating flu strain or a similar strain in prior years. So they don’t have what’s known as adaptive immunity.
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It is understandable that some pregnant women are anxious about getting a flu shot. But there is a long history of flu vaccine safety during pregnancy. The seasonal flu shot is made from purified killed virus. There is no chance that you or your baby can get an infection from the flu shot. However, pregnant women should not get the nasal vaccine. Pregnant women should get the seasonal flu shot for several reasons: •
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They can protect infants who cannot receive vaccination. The mother can pass protective antibodies to her fetus. They may help protect the baby after it’s born. If you do get the flu, you have a higher than average risk of getting pneumonia. Pneumonia lowers your blood oxygen level. This means your fetus may not receive the oxygen needed for normal development. Having the flu in pregnancy increases your risk of a miscarriage or giving birth too early.
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Some people are concerned about thimerosal, a preservative used in many vaccines. The safety of thimerosal has been extensively studied. There is no scientific evidence of any bad effects on babies when mothers get shots containing this preservative. Pregnant women may have an understandable reluctance to getting a flu shot. Certainly more testing would make all of us feel even more secure about its safety. But in balance, the risks of not having the shot are greater than the extremely low risk of significant side effects. Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.
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