Real Health Spring 2011

REALHEALTH THE GUIDE TO BLACK WELLNESS

Weighty Matters How’s Your Sex Life?

Fluoride Warning Don’t Miss This Child Safety Alert

Sad But True

Marriage May Raise Women’s HIV Risk

Montel Williams

Nutrition Plays a Huge Role in Managing His Multiple Sclerosis

SPRING 2011 $2.99 US REALHEALTHMAG.COM

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RH CONTENTS

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editor’s letter

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buzz

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Marital sex: risky business?; condoms are a black thang too; healing HIV meds’ side effects; heart attack symptoms differ for women; marijuana as a med and menu item; fluoride: How much do kids need?

nutrition

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Best breakfasts for black girls; packaged goods: Look beyond the label; say cheese please

16 COVER STORY

live well despite disease

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Media personality Montel Williams’s multiple sclerosis mantra

foods for life

You are what you eat—and it shows on your skin.

yucky bedbugs

And a surprising assortment of other allergy triggers that can cause a variety of problems, from itches to life-threatening reactions

grayed out?

Why silver is the new black. PLUS: stuff we love and a cool quiz to test how much you know about African-American hair

thoughts

Stand-up advice on asserting yourself. PLUS: how an HIV peer educator uses communication in her community to tackle stigma

Contributor Question of the Month What does the coming of spring signify to you?

Spring for me means anxiously planning for a garden filled with amazing flowers. Already, I’ve gathered all kinds of perennial and annual flower seeds and bulbs. I’m hoping it will attract butterflies and hummingbirds. —Fern Gillespie

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!

this month on REALHEALTHMAG.COM

Black Hair Rules

Former mega-model Kara Young dishes about her bad hair moments back in the day.

Check out our exclusive video.

War Is Hell

So says America’s first black female POW, Shoshana Johnson, about living with post-traumatic stress disorder.

What Are Your Fitness Habits?

Take the Real Health fitness survey and tell us what you do to stay healthy.

Real Health Forums

In this 24/7 chatroom, our readers and staff can share their stories and thoughts on the numerous health challenges facing us in today’s world.

HIV Testing at a Dental Office?

You betcha, says celebrity dentist Catrise Austin, DDS. Watch our exclusive interview with her and find out why.

EDITOR’S LETTER REAL HEALTH EDITOR-IN-CHIEF

Kate Ferguson MANAGING EDITOR

Jennifer Morton SENIOR EDITOR

Laura Whitehorn

I’m Sick of Politics

Y

es, I’m a few years late knowing this, but I never realized people could simply walk into some bodegas (ethnic stores) and buy antibiotics and other kinds of prescription drugs—without a prescription. And, yes, this is illegal—not to mention dangerous to your health.

I found out about this common practice when my friend told me about her unemployed son who got sick right as he started a new job. He really didn’t want to miss his first day there—not in this economy—so he reported for work.

Turns out, the son’s supervisor sent him home. But since he was in the job’s probationary period, he was still uninsured. He couldn’t afford to see the doctor. So what did he do? What many other sick, uninsured folks sometimes do, I learned—at least in New York City. He visited a local bodega and copped 20 antibiotic capsules for $10. (People often mistakenly use antibiotics to treat colds. But antibiotics fight bacteria-caused illnesses, and colds are caused by viruses.)

Do you see how that could be dangerous? But when I thought more about my friend’s son and his precarious situation, I had to ask myself this question: Would I do that if I were sick and uninsured? You bet I would. What’s more, so would a lot

of other people too. Would you?

And while it’s true some people might do this because they don’t like going to the doctor, there’s another truth too. Health care is still unaffordable for many Americans.

What’s also telling is that, according to Census Bureau data, the number of people in poverty in 2009 was the largest number in the 51 years for which poverty estimates are available. One in seven Americans live in poverty, as do one in four blacks.

Certainly health insurance costs for povertystricken people are too high. The 2003 Congressional Budget Office cited high insurance costs and lack of access to employment-based coverage as the two most commonly reported reasons for being uninsured. And as unemployment rises, it’s a no-brainer that the number of uninsured working-age Americans will continue to grow.

Today, despite President Obama’s efforts to keep his promise of affordable health care for all Americans by 2014, I’m concerned about the Congressional and judicial opposition that threatens to snatch away this much-needed relief.

Now that the Senate voted against repealing health care reform, there’s been talk that the debate about this issue will eventually find its way to the U.S. Supreme Court. And if the country’s highest court does take the case, it’s said that we could see a decision handed down as early as spring 2012.

I’m hoping we stay the course. Why? Because sick people shouldn’t have to selfdiagnose and self-treat their illnesses with black market meds, and insured workers shouldn’t have to resort to the same tactics because their health insurance premiums put the squeeze on already-stretched paychecks.

I’ll stop here. Now I have a big headache.

JOAN LOBIS BROWN

Here’s to your health,

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

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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) Issue No. 25. Copyright © 2011 CDM Publishing LLC. All rights reserved.

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BUZZ

In Sickness and in Health

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Love, marriage, a baby carriage and…HIV?

Most wives around the world consider married sex to be safe sex. Why bother negotiating condom use or getting tested for STIs when marriage is supposed to be about love, commitment and monogamy? But the hard truth is that for married women, the greatest risk of HIV infection comes from their husbands having extramarital sex, according to research findings revealed in the book The Secret: Love, Marriage, and HIV, by Jennifer S. Hirsch, Holly Wardlow, Daniel Jordan Smith, Harriet M. Phinney, Shanti Parikh and Constance A. Nathanson.

“The fact that a lot of women around the world get HIV from their husbands gave me chills,” says Hirsch, a medical anthropologist at Columbia University. “But discussion about this type of HIV transmission has been silenced.

We’ve really ignored that unilateral monogamy is not an effective prevention effort.”

For the study, sponsored by the U.S. National Institutes of Health, Hirsch and colleagues examined the social and economic dynamics driving extramarital affairs in five different countries: Mexico, Nigeria, Papua New Guinea, Uganda and Vietnam. The team found that in these countries, husbands most often had affairs when certain social situations were in place. For example, when husbands traveled for work they had more extramarital sex. Loneliness motivated these men to find other women who could temporarily replace their wives.

In addition, when men socialized together in the absence of their

Ignore at your peril: Marriage may up your risk of HIV.

wives but in the presence of other women (and alcohol) they’d challenge each other to see who could “score.”

Concentrating HIV prevention efforts in these settings and circumstances, Hirsch says, could lower the number of husbands who transmit HIV to their wives.

What’s more, she adds, the HIV prevention messages need to shift from promoting fidelity and supposedly monogamous safe sex. “We have to think about addressing extramarital sex at a social level,” Hirsch says.

“It’s not our job to put condoms on penises one at a time.”

Successful public health interventions work within—as opposed to ignoring—the social structures and situations in which men cheat on their wives, Hirsch says.

Examples of good prevention tactics include: making condoms available where men spend their leisure time; fighting for immigration reform so migrant workers aren’t geographically displaced and more prone to unprotected, extramarital sex; working to end stigma that causes gay or bisexual men to marry for convention but continue high risk sexual practices; and fighting the anti-condom messages from faith-based communities.

But Hirsch’s suggested game plan can also apply to HIV prevention efforts for married women right here in the United States. The best way to prevent husbands everywhere from transmitting HIV to their wives, she stresses, is having frank discussions about marital reality and not the dream.

As Hirsch sums up: “We should not be suggesting that marital sex is safe sex.”

—Cristina González realhealthmag.com

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SP RIN G 2011 RE A L H E A LTH 9

BUZZ

New Drug for Hepatitis C

African Americans Are Wrappers Black communities set the pace for condom use.

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frican Americans are at greater risk of contracting HIV/AIDS than other groups. But don’t let anyone tell you it’s because of riskier behavior.

According to the Indiana University National Sex Study, African Americans are more likely than any other ethnic group to use condoms.

Rates of condom use among black teenagers, for example, were higher than those of any other demographic—more than 90 percent among a small number of black teenagers the last time they engaged in vaginal intercourse.

The numbers are solid. The study surveyed a national representative sample of 14- to 94-year-olds, giving a more complete view of sex practices than recent sex studies, which targeted only certain populations.

So why such high marks for the black community? Study author Michael Reece, PhD, says one reason is that African Americans were more likely to self-identify as single. People in relationships are less likely to wrap up, regardless of race.

Reece also credits public health efforts that promote condom use, constantly reminding African Americans about their increased risk of contracting HIV. And guess what? Condoms are still the best defense. Using condoms consistently and correctly reduces the risk of HIV—along with other sexually transmitted infections (STIs) and unwanted pregnancies. According to analysis done by The Cochrane Collaboration, evidence shows that in “real-life” scenarios, condoms reduced HIV transmission in heterosexual sex by at least 80 percent. All without side effects, prescription refills or high drug costs.

Condoms alone won’t turn the tide on the HIV epidemic, though. The high rates of HIV in African-American communities create an unfortunate numbers game: If you’re black and you slip up, your chances of contracting HIV are disproportionately high.

Even so, Reece says, “Condoms are the cheapest, most effective form of STI Source: The Centers for Disease Control and Prevention (CDC), 2010 prevention.”

—Diana Scholl

The age the majority of HIV-positive Americans will be by 2015.

For many African Americans with hepatitis C, treatment doesn’t work. Telaprevir, an experimental drug, may change that.

In trials, even some people who had failed to clear hep C in previous treatment succeeded when telaprevir was added to the usual regimen (pegylated interferon plus ribavirin). Adding telaprevir also shortened treatment time for some people.

The FDA might approve telaprevir this year. —LW

Blood From a Dragon HIV drugs can cause side effects.

But other meds can clear them up.

The drugs that treat HIV have extended people’s lives so that an HIV diagnosis is no longer a death sentence. But while they suppress HIV, many of the meds also cause side effects that can make life difficult. A common complaint: diarrhea.

Enter the dragon—or, more accurately, the extract of a plant called sangre de grado, or dragon’s blood.

The experimental drug crofelemer, made from this plant, has proved effective at controlling diarrhea. Crofelemer is now in Phase III clinical trials, moving toward FDA approval.

Healing such side effects does more than make people’s lives more comfortable.

It also helps them take all of their HIV drug doses—crucial, because missing doses can let the virus mutate and become resistant to the meds. —Laura Whitehorn SP RIN G 2011 RE A L H E A LTH 1 3

BUZZ

Cardiac Maneuvers

What women should know about heart attack symptoms

W

hile women account for nearly half of all heart attack deaths, they’re less likely than men to recognize the symptoms of a heart attack when it’s happening to them, which delays getting treatment and may cost them their lives, according to the National Heart, Lung and Blood Institute.

Men and women may experience different heart attack symptoms.

Men experience the classic heart attack signs of pressure in the chest or a sense of tightness or constriction.

If a woman doesn’t feel Number of American this, she women who died of some might not form of cardiovascular connect her disease in 2006. ailment to a Source: American heart attack,

432,709 Heart Association

May be just what the doctor ordered

People have used marijuana as medicine for thousands of years. “It’s used to treat chronic pain, muscle spasms, seizures, mood disorders and nausea, among other ailments,” says Gregory Carter, MD, a professor of rehabilitation medicine at the University of Washington at Seattle.

In the 14 states where medical marijuana is legal, patients are allowed to purchase prescribed amounts at certified dispensaries or grow limited amounts in their

home. But now collectives across the country are going a step further and delivering cannabis to patients as an ingredient included in food.

At the Ganja Gourmet in Denver, customers can get medical marijuana in lasagna, vegetables and even cheesecake. “It works very well [in foods],” Carter says.

“It lasts much longer and may even be a bit more potent.”

In addition, compared with most major prescription drugs, medical marijuana’s side effects are much less intense because cannabis is an extremely well-tolerated drug, Carter says.

Perhaps that’s why a lot of patients who use it may not mind saving room for a second serving. —Cristina González

1 4 R E A L H E A LTH S P R IN G 2011

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realhealthmag.com

What’s on Tap? Although many dentists believe fluoridated water defends against dental decay, some say kids are getting harmful doses of the mineral.

Fluoride is everywhere—in plants, soil, even the water we drink. But too much of a good thing can be bad for you.

Excess fluoride increases infants’ chances of developing enamel fluorosis—unsightly spotting, pitting and staining of the outer enamel layer of the teeth—and it poses additional health risks, according to Bill Osmunson, DDS, a dentist in private practice in Oregon and Washington.

The Centers for Disease Control and Prevention and the American Dental Association have warned parents to avoid regularly using fluoridated water to mix infant formula. And a 2006 report recommended that the EPA lower the amount it allows to be added in our water— in fact, Osmunson and many other doctors have joined a movement to stop water fluoridation altogether. “The problem is that some people are ingesting too much fluoride,” he says.

It’s difficult to avoid excess fluoride, but Osmunson offers two simple tips: Buy bottled water, and make sure your children are spitting and rinsing after brushing with fluoride toothpaste.

—Kate Ferguson

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CANNABIS CUISINE

says Judith Hochman, director of the Cardiovascular Clinical Research Center at the New York University School of Medicine.

What are the female symptoms?

Shortness of breath, profound fatigue (especially for elderly women), back pain and tightness in the neck. Nausea or vomiting may also signal the beginning of a heart attack. If you detect these symptoms—or the more classic ones—immediately dial 911. Don’t drive yourself to the hospital or wait for the situation to subside (by then the damage will be done).

Though some cardiac disease risk is in the genes and is heightened by high cholesterol or diabetes, you can lower your risk with regular exercise and a balanced diet—healthful advice that crosses the gender divide.

—Katie Karlson

NUTRITION

Say No Weigh to Bad Breakfasts This first meal is especially important for black girls.

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18%

Many nutritionists agree that breakfast is the most important meal of the day. What that means is starting your mornings with nutritious eats is essential to your overall health. And with obesity rates rising among African Americans, it’s especially vital for black teen girls to make breakfast a healthy one. Why? Good breakfast choices help girls avoid packing on excess pounds. At the same time, healthy eats can lower total cholesterol levels and LDL (“bad”) cholesterol. (Too much LDL cholesterol can clog arteries and put folks at increased risk of heart disease.)

Studies show that overweight African Americans also have higher rates of strokes, diabetes and high blood pressure.

“An excellent way [for black girls and other African Americans] to avoid these chronic diseases is to maintain or work toward a healthy weight,” says Roxanne Davis-Cote, MPH, RD, a nutritionist at Beaufort Memorial Hospital in Beaufort, South Carolina. “A nutritious breakfast is an important part of that process.” Best bets for breakfast? Whole grain cereals, low-fat yogurts and fresh fruits. They score an A+ in the fight against obesity.

—Janique Burke

The amount of extra calories restaurant meals contained compared with what the eateries reported.

Source: “The Accuracy of Stated Energy Contents of…Foods,” Journal of the American Dietetic Association, January 2010

AMERICAN, CHEDDAR, SWISS OR JACK

Exposed The naked truth about “healthy” foods

No matter which variety you choose, cheese can be a tasty part of a healthy diet.

When choosing foods for home-cooked meals, it’s important to know exactly what you’re putting on your plate. Bold nutrition labels promoting foods as “All Natural” or “Fat-Free” could contain hidden ingredients such as sugar, saturated fats, trans fats and salt. These less-than-healthy additions can diminish your meal’s nutritional value and possibly affect your health.

Pay special attention to salads, soups and fruit smoothies—they’re considered healthy foods, but the way they’re prepared is key to their nutritional value.

The leafy greens in salads become unwholesome when drowned in fatty dressings, smothered with cheese or deluged with croutons. Instead, add veggies such as sun-dried tomatoes and spinach to ensure a healthful meal.

In addition, watch the salt content in packaged soups. Try making your own version of this nourishing meal with fresh,

Like all dairy products, cheese is a rich source of calcium and protein. In addition, this nutritious milk by-product helps protect your teeth against cavities by reducing the enamel-eroding acids created by dental plaque.

But while these benefits are a plus, you can get too much of a good thing.

Cheese is fattening if not eaten in moderation. That means it’s important to compare calories and fat content.

Softer cheeses, such as goat and feta, have fewer calories. Strong or savory cheeses have more flavor so you use less. And if you eat more than one ounce each day, choose reduced-, low- or nonfat varieties.

—Willette Francis

low-sodium natural ingredients. Similarly, to make nutritious and tasty fruit smoothies sans added sugar, also keep it simple. Just use two kinds of berries and yogurt.

In general, preparing food from scratch is a sure way to guarantee healthier meals. If that’s not feasible, learn to spot unhealthy foods with a hard read of the label. —JB

PERSONAL

BEST What having a consistently inconsistent disease taught Montel Williams about becoming more proactive about treating his multiple sclerosis

By Kate Ferguson Photograph by Eric McNatt

welve years ago, doctors shocked Montel Williams with the news that he had multiple sclerosis (MS).

He was 43 years old and seemed pretty healthy—except for the excruciating foot pain he’d started to experience. At the time, the Emmy Award–winning talk show host (he has since retired) was also shooting an episode of the popular TV show Touched by an Angel. He was terrified that his health issues would cost him his acting career, so he swore his doctors and the few people who knew to secrecy.

1 6 RE A L H E A LTH S P R IN G 2011

The popular, outspoken media personality, famous for his hard-hitting, issue-oriented programs, found himself crushed between chronic MS-caused bouts of pain and a nonstop barrage of negative thoughts that alienated him from family, friends and coworkers. Afraid he’d soon end up a wheelchair-bound burden to his family, Williams plunged into depression. Shortly after his diagnosis, just after midnight one morning, he spread some towels on the floor of his walk-in closet and laid several guns from his collection on the floor. Williams disassembled a few of them, but his eyes

For Montel Williams, living with multiple sclerosis means at any moment, his smile could be replaced with a grimace of pain.

lingered on a .357-caliber Magnum.

That, he decided, would be the most effective weapon to end the pain.

Williams put the gun to his head and then moved it toward his mouth. He paused. He didn’t want his death to look like suicide. He wanted people to think he’d accidentally shot himself while cleaning his weapons. That’s why he’d taken apart some of the guns.

Williams held the gun then twirled the firearm around by its trigger. He was afraid to shoot himself but hoped the gun would go off.

Finally, Williams put the Magnum down. He went to bed and fell asleep.

Several days later, though, he tried

“I started to really do some hard research myself,” Williams says. “I took my disease apart the way an engineer would. I sought out information about MS from the most prestigious health institutions around the world. And I started talking to doctors to try and figure out [what was] truth and [what was] theory about this disease.”

What Williams learned about multiple sclerosis is that the still incurable condition is considered an autoimmune disease (when the body’s immune system mistakenly attacks normal body tissues). With MS, the body’s immune system attacks the brain and spinal cord,

FRUITS AND VEGETABLES ARE AMONG NATURE’S MOST POWERFUL HEALING FOODS. suicide again by “accidentally tripping” and falling in front of a speeding car. The driver swerved around Williams and left him unharmed.

Fate had other plans for him.

Today, Williams admits that he didn’t handle MS very well immediately after his diagnosis. But when he did decide to rally, he chose to take a proactive approach to managing his illness.

1 8 RE A L H E A LTH S P R IN G 2011

causing scar tissue to build up when the attack destroys the myelin (a protective insulation) covering the nerves. Without myelin, electrical signals can’t be transmitted throughout the brain and spinal cord. This communication breakdown is what causes MS’s wide range of symptoms.

For Williams, the MS symptoms spanned a 20-year period, starting

with intermittent episodes of unexplained health issues ranging from temporary vision loss to extended bouts of heavy nosebleeds to leg and foot pains.

Although Williams didn’t know it at the time, these are classic signs of MS. But because the disease is so complex and the symptoms so varied among individuals, patients often go undiagnosed for long periods. And in Williams’s case, the health crises seemed to resolve themselves and disappear. In fact, during one episode of ill health, docs actually accused him of faking it, he says in his candid memoir, Climbing Higher.

In fact, a big challenge to diagnosing MS is that early tests may show nothing wrong, even among patients who have a lot of abnormal pain. Later on, some patients are diagnosed with MS, but a vast majority are not, explains Carolyn Barley Britton, MD, MS, an associate professor of clinical neurology at New York City’s Columbia University Medical Center. “So, in the absence of any [definitive] examination findings, doctors can only regard a patient as normal.”

till, for those who do develop MS, the journey to a definitive diagnosis is frustrating and long. Because MS symptoms are often vague and fleeting, doctors must confirm two or more isolated signs that could be caused by the disease. In addition, those symptoms must have lasted for at least 24 hours and occurred about a month apart. Doctors can’t officially diagnose a patient as having multiple sclerosis until he or she experiences two or more of these attacks. What’s more, a patient’s magnetic resonance imaging (MRI) test must show the presence of lesions (damaged areas caused by a loss of myelin).

Williams’s diagnosis was long in

coming because no doctor had connected the dots and linked the symptoms he’d experienced through the years with MS. For example, the sudden vision loss (called optic neuritis) he’d suffered commonly precedes MS, but many other health issues can cause this problem. “We simply don’t have a good diagnostic test that tells you the person is going to have certain symptoms early in the disease,” Britton says. “That’s what we need, some definitive test that gives you near 100 percent certainty that [specific] symptoms are going to develop into MS—before the condition progresses.”

After his diagnosis, Williams continued to work, but he often experienced fiery leg and foot pain that brought him near tears. As his disease symptoms multiplied, Williams decided to educate himself about MS, eventually creating a personalized disease management program.

To help slow his disease’s progress, Williams’s doctors prescribed one of the “ABC” drugs—Avonex, Betaseron and Copaxone. (In his memoir, Williams declined to name the drug to avoid any perception he’s endorsing the med.) These “diseasemodifying” meds are among a grouping of several drugs that help lessen the frequency and severity of MS attacks, reduce the accumulation of lesions in the brain and slow the progression of a variety of disabilities the disease causes.

But in addition to the meds prescribed, Williams included nutritional therapy in his treatment.

“We all have choices,” he says. “I made a choice to seek out what I needed for me.”

Since he started treatment, Williams continues to experience some MS symptoms, such as occasional leg, feet and skin pain and sexual dysfunction. One of the things he says works for him is following an anti-inflammation diet.

(Inflammation is an immune system response to injury or infection that causes pain, redness, heat and swelling in the affected area.)

“Nature has given us some unbelievable anti-inf lammatories,” Williams says. “They’re called

fruits and vegetables.”

Williams started drinking blendermade fruit-and-veggie drinks each day. “What’s kept me on this [regimen] for almost five years straight is the neuropathic pain in my feet,” he says, referring to the pain caused by nervous system damage or dysfunction. “When I miss drinking these foods, my feet go back on fire.”

In general, many doctors agree that taking care of your health to the maximum degree possible with proper nutrition, supplements and exercise is a good thing. And that’s even more so for people experiencing immune system diseases such as MS. “Whenever you have a chronic illness, taking care of yourself in a holistic way will benefit you,” Britton says. “These are noharm-no-foul therapies, so I think they’re OK.” Certainly, Williams believes that the colorful fruits and veggies he packs into his smoothies are a cru-

Does Race Determine How Multiple Sclerosis Affects You? Studies say yes, but the disease’s differences may go deeper than just skin color.

Whites develop multiple sclerosis (MS)—a chronic and complex disease of the central nervous system—twice as often as blacks.

But the disease also seems to affect each group differently in terms of its severity, symptoms and the time it strikes.

One study finding, published last year in an issue of the medical journal Neurology, showed that African-American MS patients had greater disease severity compared with white Americans suffering from the condition, even though those blacks had the illness for a shorter time.

What’s more, earlier study findings, published in a 2007 issue of the same journal, showed that blacks with MS experienced more difficulty walking than their white counterparts. In MS, recent genetic studies have begun to identify certain

cial component of his overall MS treatment program. (But he also stresses that people should check with their doctors before engaging in any treatment regimen.)

“We can’t credit it just to drinking these green smoothies,” Williams says. “It has to be attributed to everything that I am doing.”

Williams also includes chicken, fish and even red meat in his diet “once every eight to nine days,” and he also exercises daily.

At one point, when he was first diagnosed with MS, Williams says, a doctor told him he’d probably be in a wheelchair within five years.

“At first I felt like smacking him out of the room,” Williams says. “But after I thought about it, I determined that I must be the one who owns the definition of who I am and where I will end up.

“I can’t stop this disease,” Williams adds. “But I can sure put up a good fight.” ■ genes that are associated with MS. According to John R. Rinker, MD, a member of the American Academy of Neurology and the earlier study’s lead author, there’s a possibility that these genes are unevenly distributed between ethnic groups, which might explain why different population groups are more susceptible to some diseases.

An even earlier study showed that doctors diagnosed blacks with MS at a later age than whites and with more diverse and severe symptoms.

But that race-related difference may also be because many black people tend to delay seeking medical attention until an illness is very advanced, says Carolyn Barley Britton, MD, MS, an associate professor of clinical neurology at New York City’s Columbia University Medical Center.

“Many people in our community are very drug-averse,” Britton says. “It’s a common scenario. People get evaluated much later and begin treatment when they are already [far] along in their disease process.”

All that said, and because MS has so many symptoms, the best bet is for people to get checked out when they develop any unusual signs that indicate something may be wrong. It’s always better to be safe than sorry, don’t you think?

—KF

You may not think of food as part of your skin care regimen, but the vitamins and minerals in a well-balanced diet indeed provide nutrients that keep your body’s largest organ healthy and gorgeous.

GETTY IMAGES/KARIN DREYER

BY WILLETTE FRANCIS

2 0 RE A L H E A LTH S P R IN G 2011

Science test: Take a closer look at how skin responds to more fruits and veggies in your diet.

What part of the body do you first notice when you look at other people? Is it the face? What about the face’s covering? That’s the skin. It covers the entire body and protects what’s inside.

In addition, the skin controls body temperature, keeps out infection, acts as a waterproof barrier, protects the tissues underneath and mends itself when damaged. To do all this, skin needs to be fed a nutritious diet so it can continue to protect your body and give you healthy, beautiful skin.

And although many people don’t connect healthy, beautiful skin to

with a balanced diet chock-full of vitamins, minerals and other nutrients that promote healthy skin from the inside out.

But what are the best sources of these essential nutrients? According to the U.S. Department of Agriculture’s (USDA) daily food guide—perhaps better known as the food pyramid (myfoodpyramid.gov)—you can get the skin of your dreams from a diet that’s rich in fruits, vegetables, whole grains, fat-free or low-fat milk and dairy products, lean meats, poultry, fish, beans, eggs and nuts. It should also be low in saturated and trans fats, cholesterol, salt and added sugar.

Want more specifics? Check out the foods listed below before you organize your shopping list. These good eats can do wonders to ensure you’ll have a glowing, healthy complexion: Orange veggies and leafy greens.

Nature loaded carrots, sweet potatoes, butternut squash and acorn squash with beta-carotene—a natural pigment also found in greencolored veggies, such as collards, broccoli, spinach and kale. The body converts betacarotene into vitamin A, which helps maintain and repair skin tissue. Without the right levels of this vitamin, skin becomes dry and flaky. This is why cosmetic companies may include chemically synthesized vitamin A in their products. The food nutrient is known to reduce lines and wrinkles, control acne and provide relief for certain skin conditions. But the potency of any vitamins found in manufactured creams (called cosmeceuticals) is questionable—unless it is prescription-strength vitamin A, a.k.a. Retin-A or tretinoin. (Dermatologists prescribe it to fight acne and erase wrinkles.) Besides this prescription med, the best source of vitamin A— and other nutrients—is food. Why

Is your skin starved for food? Quell the hunger with nutrientrich goodies. what they put in their mouths, nutritionist Rovenia Brock, PhD, (a.k.a.

Dr. Ro) stresses that the secret to great skin has nothing to do with the concoctions contained in pricey cosmetic creams in fancy jars and bottles. Healthy, beautiful skin starts 2 2 RE A L H E A LTH S P R IN G 2011

slather on expensive creams for iffy skin benefits when you can eat delicious fruits and vegetables and feed your body with the nutrient in a form it can readily absorb?

Low-fat yogurt.

Not only is this dairy product one of the best food sources of good-foryour-skin vitamin A, but it also contains “live” bacteria (lactobacillus acidophilus) that’s good for digestive health. Two for one? Not bad, right?

In addition, this bacteria found in yogurt is touted as an acne remedy.

(But Medline Plus, the National Institutes of Health website, says there’s insufficient evidence to substantiate this claim.)

Citrus fruits, tomatoes, berries, papaya, melon and bell peppers.

These rich varieties of colorful produce share a common trait: They’re rich in vitamin C. Foods with vitamin C contain flavanoids, organic compounds in plants that aid collagen production. Collagen is a natural protein that makes skin smooth and supple. Plus, vitamin C also counteracts the effects of sun exposure.

Wheat germ, canola, safflower and sunflower oils, hazelnuts and almonds.

These oils and nuts contain vitamin E, which is also an antioxidant.

Antioxidants reduce skin damage caused by the free radicals, which are damaging by-products of sunlight, smoke and pollution. (Free radicals break down collagen and elastin, another skin protein, and cause the skin to wrinkle and age.)

Vitamins E and C team up to protect skin against damage from sun exposure and free radicals.

Whole grains, mushrooms and tuna.

Scientists believe the selenium contained in whole grains, mushrooms and tuna helps prevent skin cancer.

It does so by protecting skin against sun damage and reducing the chances of sunburn. In addition, studies also show that patients who took daily selenium supplements experienced fewer skin cancer malignancies.

What’s more, these patients were less likely to die of cancer.

Oysters, lean meat and poultry.

Have acne-prone skin? The zinc found in this shellfish and these meats can work like edible Clearasil.

How? By taming the skin’s oil production, the zinc helps control acne breakouts and generally help clear skin sooner.

Cold-water salmon, sardines and mackerel.

These tasty fish contain essential fatty acids (EFAs), such as omega-3 and omega-6. Without EFAs, skin becomes more prone to dryness, inflammation and the appearance of white- and blackheads. Of these two EFAs, many people experience an omega-3 deficiency. This causes the skin to produce a more irritating form of oil.

Can’t seem to cram all these nutrients into your diet? Take this advice from Dr. Ro: “Include fruit and veggies in all meals by adding berries to whole grain cereals and salads; add omega-3-rich flaxseeds to salads and cereals; grab a hand of almonds as a snack; eat at least three to four different-colored fruits and veggies daily; drink at least eight 8-ounce glasses of water daily; add veggies to soup stews and whole-grain pizza; and cook more meals from scratch.”

And for those who regularly munch on less-than-healthy snacks or meals, don’t fret. “Start by gradually eliminating those foods that are the most damaging––sugar and junk food,” Dr. Ro says. “That means inflammation-causing sweet foods, such as cookies, candies, cakes, pies and other empty-calorie foods. They cause puffy-looking skin that’s lacking in moisture.”

As for sodium-saturated foods (salty snacks, processed meats, cheeses and others of this kind), they can cause puffiness too, explains Dr. Ro, and this results in skin losing its youthful, dewy look.

What’s more, a diet low in good fats (monounsaturated and the EFAs previously mentioned) and colorful fruits and vegetables may cause dry skin, inflammation, wrinkles, discoloration and blotchiness and contribute to aging, sagging skin overall.

But what about people who have skin conditions such as acne, eczema, rosacea or psoriasis? How does this diet affect their skin issues?

Consider this. A recent study showed that acne patients who ate fewer carbohydrates saw a reduction in acne flare-ups. As a result, researchers suggested a link between a low-sugar diet and acne improvement. And although this one finding isn’t enough for docs to definitively confirm that certain diets can improve acne problems, it does arm researchers with some advice: If you notice an acne flare from eating certain foods, then you should avoid those foods.

And ditto for many rosacea patients. These are folks who, after eating spicy foods or drinking alcoholic beverages, experience the facial redness and swelling characterized by the condition. Other foods that cause rosacea flare-ups are liver, vinegar, soy sauce, dairy products, certain fruits and veggies, hot chocolate, cider, tea and coffee.

In addition, docs warn those with eczema—a condition that causes dry, red and itchy patches on the skin— to avoid foods that worsen these symptoms, such as eggs, milk, peanuts, soy, wheat and fish. (Some patients even report that chocolate, coffee, alcohol, tomatoes and sugar trigger the condition.)

If this is the case with you, it’s important to discuss your diet with your dermatologist. In addition, it’s also helpful to keep a diary of what foods trigger your skin condition— and be sure to share the findings with your skin doctor.

But no discussion about skin nutrition is complete without mentioning the best drink for your skin.

“Hand’s down, it’s water of course.

‘Nature’s champagne’ works best for healthy, dewy skin,” Dr. Ro says.

(See sidebar for more on this.)

And lastly, your skin may also benefit by applying some foods topically. For example, a warm-milk bath, aloe vera gel or honey can hydrate and moisturize the skin. Itching? Try an oatmeal bath. See, food can make a delicious difference in your skin’s health and appearance. ■

LIQUID SKIN SUPPORT

Raise a glass to these revitalizing refreshments.

H2O Besides being essential to maintaining life, water hydrates the skin so it doesn’t become parched and dry—in short, aqua helps you maintain a youthful appearance. It bathes each cell in the body. Doesn’t matter if it’s bottled or tap, any good clean water will do the trick.

GREEN TEA The polyphenols— chemicals with potent antioxidant properties—in green tea could benefit overall skin health. In addition, these antioxidant properties may deactivate free radicals, by-products of sunlight, smoke and toxins that damage cells and tissue. What’s more, studies show green tea may offer protective anti-inflammatory properties that reduce the risk of skin cancer.

BERRY DRINKS

You’ll find any number of these trendy plant-juice supplements in most health food stores. And although many can’t claim science-backed health benefits, Dr. Ro endorses one of the latest: Revitalize & Renew by Sibu Beauty.

It contains sea buckthorn—a berry found in the Himalayas that’s rich in omega-3, -6, -7 and -9 (essential fatty acids, or EFAs) and beta-carotene. “A one-ounce shot each day does the trick to help you achieve healthy beautiful glowing skin,” Dr. Ro says.

TOMATO JUICE This bloodred beverage boasts high levels of lycopene, an antioxidant that protects the skin from the sun. The body best absorbs lycopene from processed tomatoes, such as tomato juice or soup.

RED WINE

The grapes used to make this fine spirit contain high concentrations of skin-protecting polyphenols. Uncork a cabernet or pinot noir; these have the highest levels of the antioxidant.

—WF

WHEN BEDBUGS BITE AND OTHER ALLERGY AND

ASTHMA-CAUSING DRAMA

Sleep tight and don’t let the bedbugs bite

is no longer a benign nursery rhyme. Bedbugs have re-emerged as a 21st century menace. The night crawlers have crept into the category of insects that cause allergic reactions. A bedbug bite has been known to lead to scars, infections and, in some extreme circumstances, a life-threatening, wholebody allergic reaction called anaphylaxis.

Allergens—substances that can set off allergies— can lurk in countless materials, many of them obvi-

ous, but others seemingly benign and downright surprising: in cosmetics and jewelry, in chamomile tea, cell phones and sperm, even in activities such as body piercing, tattooing and kissing. As allergy season starts, Real Health looks at a few of the allergens people don’t usually guard against.

BEDBUGS

Today, talk about these almost invisible insects has created a niche in the extermination industry. But definitive data about people with severe allergic reactions to bedbugs remain sparse. “We don’t have any real data about that because people are embarrassed

(ALL ILLUSTRATIONS) DREAMSTIME.COM: (COSMETICS) SELENKA; (BEDBUGS) MORGAN OLIVER; (TREE) SAMINAYAHIYA; (CELL PHONE) DANIEL SOONS

BY FERN GILLESPIE

to talk about being bitten by bedbugs,” explains allergist Richard D. deShazo, MD, of the University of Mississippi Medical Center in Jackson. “Most of the data we have comes from our own research.”

Indeed, what is definitive, deShazo says, is the significant increase he’s seen in the number of patients coming to see him because of allergic reactions to bedbug bites.

Many of these patients, deShazo says, blame these allergic episodes on fleas, mosquitoes, mites and other insects because either they don’t think it may be bedbug-related or they don’t want to acknowledge the problem.

A well-known allergist who specializes in allergic reactions to insect bites, deShazo serves on a committee of the American College of Allergy, Asthma and Immunology (ACAAI) that studies the critters. He wrote an article about bedbugs and the consequences of being bitten by them that was published in the April 2009 issue of the Journal of the American Medical Association (JAMA).

According to deShazo, most people never know they’re bitten because they’re not allergic to bedbugs. But more people have allergic reactions to bedbug bites than to the stings of other insects, he explains.

Those with bedbug allergies develop intense itching on localized areas.

When they scratch these areas, the skin may become infected and lead to scarring. And if there’s a large enough infestation, scars can develop all over the body. In very rare cases, bedbugs bites have caused severe anaphylactic reactions, deShazo says.

According to deShazo, bedbug infestation is a worldwide epidemic that reflects the insects’ resistance to the usual pesticides that hotels and motels use to dispatch them. Anyone who travels nowadays should check for bedbugs so they don’t come back home with you, deShazo cautions. Why? “Because it’s very difficult to get rid of them once an infestation occurs,” he says.

Well, OK, but just how do you detect these creepy critters? Check for their droppings, which are often tinged with blood, deShazo advises. And carefully peel back mattress covers and check along the rim. In addition, scrutinize wall cracks and peeling paint that may hide bedbugs. Also take a close look at picture frames or cracks in wooden furniture, particularly antiques.

CELL PHONES

The boom in these communication devices is connected to an increase of related allergies. The culprit? Nickel, a common allergen that affects up to 17 percent of women and 3 percent of men, according to the ACAAI. While nickel is found in everyday objects such as keys, coins, paper clips, jewelry, watches and eyeglass frames, our contact with these items is generally brief. Not so with cell phones, which we constantly press against our faces, resulting in contact dermatitis. Symptoms of nickel allergy include dry, itchy patches on cheeks, jawlines and ears. Other signs include redness, swelling, itching, eczema, blistering, lesions and sometimes oozing and scarred skin.

These signs of contact dermatitis can result from exposure to even a small amount of the allergen being absorbed into the skin, explains Michael Foggs, MD, chief of Allergy, Asthma & Immunology for Advocate Medical Group & Advocate Health Care, a health care network in Chicago. (Foggs is considered one of the nation’s leading experts on allergies and asthma among African Americans.)

BEDBUG INFESTATION IS A WORLDWIDE EPIDEMIC THAT REFLECTS THE INSECTS’ RESISTANCE TO THE USUAL PESTICIDES.

2 6 RE A L H E A LTH S P R IN G 2011

TATTOOS

Allergies caused by body art are also skin deep.

According to the ACAAI, 24 percent of people ages 18 to 50 sport tattoos. This creative outlet of selfexpression puts wearers of body art at risk of allergic reactions from the pigments used to color tattoo dyes. “With tattoos, the [possibly offending] pigment is in your skin permanently, unless it’s removed,” Foggs says.

“But in most cases you can remove all the pigment.”

BODY PIERCING

No longer the exclusive domain of ears, piercings now grace the nose, lips, belly, eyebrow, tongue, nipples and other sensitive body parts, often showing off jewelry and other adornments. According to the ACAAI, 14 percent of people ages 18 to 50 have had body piercing done. And some have experienced nickel-caused allergic reactions from metal jewelry. “Allergists have one recommendation,” Foggs stresses. “Remove the agent causing the contact dermatitis.” In addition, some researchers suggest no ear piercing for children until they are past age 10.

COSMETICS

For some people, an allergic reaction to cosmetics is a beauty backlash. Fragrances and preservatives contained in cosmetics can cause allergy symptoms, such as redness, itching, crusting, swelling, blistering, dryness, scaliness and thickening of the skin. Nearly 22 percent of everyone patch-tested for allergies reacts to chemicals in cosmetics, according to allergist Luz Fonacier, MD, an ACAAI fellow. The average person uses 12 personal products a day. Those 12 products may contain up to 168 chemicals, many of which can be irritants or cause allergies, Fonacier notes. Cosmetics culprits may be found in fragrances, foundations, mascara, eyeliner, nail polish and more. At his practice, Foggs has been noticing another issue too: “I’ve seen several patients during the past year where lip balm or lipstick contain agents that cause the skin to blister,” he says.

HERBS

Even these all-natural botanicals are not necessarily benign. Herbal teas can actually worsen some people’s allergies. “Certain natural substances can have side effects, just like medicines,” says allergist William Silvers, MD. Silvers specializes in allergy complementary medicine at the Allergy, Asthma and Immunology Clinic of Colorado. For example, he mentions chamomile tea. “People with ragweed and daisy allergies will get worse while drinking chamomile tea,” Silvers says, explaining that chamomile and ragweed are part of the same plant family.

WHAT’S THE CONNECTION BETWEEN ALLERGIES AND ASTHMA?

Experts are not sure what causes asthma—a chronic respiratory disease that makes breathing difficult.

What they do know is that people who have allergies are at a much higher risk of developing asthma. Why? Because certain substances that trigger allergies, such as pollen, dust mites and pet dander, can also trigger an asthma attack.

Symptoms of allergic asthma attacks or allergyinduced asthma include shortness of breath, wheezing and chest tightness. And, remember those nasty bedbugs? Well, the insects can trigger an allergic asthma attack when their dried outer skins and feces become airborne and inhaled by susceptible people.

But in all these instances—whether the culprits are bedbugs or cell phones—the true cause of the allergy often goes undiagnosed.

What’s the best solution when you can’t figure out the source of the problem? Here’s deShazo’s advice: “If you have allergies or asthma and you don’t know the cause of your skin irritation, see your allergist.”

Only a doctor can confirm an allergic asthma diagnosis. The way it’s done is through a skin or blood test to see what your asthma triggers are.

Yes, asthma—from allergies or other triggers—is currently an incurable illness. But with proper management, people can still lead healthy and active lives. ■

ITCHY FINGERS?

For each of these triggers, specialists recommend ways to avoid allergic reactions.

KISSING Before locking lips with a loved one who has a food allergy, non-allergic partners should brush their teeth, rinse their mouths and avoid the offending food for 16 to 24 hours beforehand. (Note: But even these steps may not help in some cases.)

SEMEN & SPERMICIDES A love crisis can happen when a person is allergic to spermicides, lubricants, latex or semen. Those allergic to their partner’s semen should try using condoms or getting desensitization immunotherapy. In mild cases, antihistamines have also helped.

FLU SHOTS Before getting a flu shot, people should get tested by an allergist for the specific vaccine if they have egg or gelatin allergies or a history of severe reaction to any influenza vaccine.

CELL PHONES To avoid an allergic reaction to nickel-plated cell phones, consider covering the device with plastic film and using a wireless earpiece, or switch to a cell phone that doesn’t contain metal parts that come into contact with the skin.

BEE STINGS Be cautious outdoors. Bees are attracted to bright colors, perfumes, colognes, open cans and cups and trash cans. Those highly allergic should carry an epinephrine self-injection pen (EpiPen) and consider allergy shots. Those have a 90 percent success rate.

STRESS This physical and emotional response to pressure can trigger an allergic reaction and worsen allergies.

Reduce stress with exercise; follow a healthy diet; and use HEPA filters to clean allergy-triggering dust from home air.

ASTHMA Manage asthma daily with an Asthma Action Plan, a handy guide and informative wallet card. They’re available online from the U.S. National Heart, Lung, and Blood Institute’s National Asthma Education and Prevention Program. Record the severity of your asthma and the success of your meds. Track asthma attacks and triggers and see techniques to avoid them. Review your action plan and findings with an allergist every one to six months.

Finally, see a board-certified allergist regularly.—FG

GOING

GRAY Although color loss is inevitable, science is trying to find a way to keep hair in the black.

BY GERRIE E. SUMMERS

ew research shows that hair turns gray as a result of a chemical chain reaction that causes hair to bleach itself from the inside out. Alas, scientists have yet to find a way to stop that chemical chain reaction or slow down the appearance of those silvery strands.

And until they do, researchers are ramping up efforts to see how the aging process whitens hair.

While pursuing this goal, scientists at the University of Bradford in the United Kingdom found that gray hair is the result of a buildup of hydrogen peroxide in the hair’s cells, which blocks the normal creation of melanin (the dark pigment found in

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hair and skin). This buildup occurs because aging bodies may help slow down hair’s natural graying process, this produce less catalase, an enzyme that breaks down doesn’t prevent it. “While there are no treatments to stop hydrogen peroxide in hair into water and oxygen. The hair from naturally going gray, there are ways to improve overall hair and scalp health, which [in turn] can prevent result? Good-bye black and hello gray.

But here’s promising news. Manufacturers are producing premature graying,” Bank says.

What this means is that until a product can actually supplements that contain catalase. One called Go Away Gray also provides other well-known, go-away-gray stop silvery strands from sprouting, then permanent dyes ingredients, such as horsetail, foti, PABA and nettle root. are the best bet for fully covering gray—especially if The product promises that these ingredients can restore you’re sporting 50 percent or more silvered hair. But hair hair’s natural color and prevent gray hairs. Naturopathic dyes raise health concerns. Some chemical ingredients physician Valerie Lane Simonsen, ND, finds the prod- in these products are believed to be unsafe. Another uct “interesting” but cautions that your lifestyle and option? Try safer semi-permanent dyes and touch-up kits overall health determine how your hair responds to that temporarily cover gray. And don’t overlook tempoanti-graying treatments. So don’t toss your bottle of rary fixes too. Mascara-type wands and cover sticks can color gray hair in between salon visits. But these tend to Dark & Lovely just yet.

“The bottom line for gray-hair prevention is knowing rub off. Word is, though, a new hair color marker called that graying is caused by multiple factors, which are not TouchBack withstands rubbing and brushing and lasts all under our control,” says New York dermatologist until shampooed out. Another cover-gray option is to use David E. Bank, MD. He points to an enzyme called natural dyes. “A rinse made by boiling coconut oil and methionine sulfoxide reductase A and B (MSR A and B). henna leaves, for example, can eventually turn gray hair It helps follicles repair damage caused by hydrogen perox- brown,” Bank says.

Still, more women are forgoing neverending touch-ups ide. But like catalase, this enzyme also declines with age.

And without enough MSR A and B, the body struggles to and learning to accept, love and wear their silver locks— produce enough of another enzyme, tyrosinase, which and to do so with style.

Celebrity stylist and SoftSheen-Carson artistic director helps melanin reach the hair shaft.

“Melanin is what gives our hair its color. Hence it’s Johnny Wright observes: “Going gray is a very natural prosafe to say that replacing a single component, catalase, cess. Many women are embracing what [God] gave them which these [kinds of products] claim to do, will not and enhancing their gray hair, and they look amazing. The solve the problem of graying hairs caused by age or key is, start with healthy hair and a great cut.” ■ heredity,” Bank explains.

“But in cases where gray hair is caused only by a catalase deficiency, the Take the Real Health challenge and see. (Note: Some questions have multiple answers.) supplement may work.”

The catalase supplement isn’t the only product 1. In general, how often c) Use the best shampoo for b) Greasy products such as on the market advertised should you wash black hair? your hair type and scalp lanolin as a cure for graying hair. a) Every day c) Penetrating conditioners Many people turn to b) Once a week 5. Braiding the hair... and lightweight oils c) Once every two weeks a) Makes it grow Chinese medicine, a treatb) Does not increase the rate 9. What statement(s) apply ment that links hair’s to black hair?

2. Trim hair every six of hair growth health with clean blood. weeks to… c) Can sometimes cause a) Curly textures hold onto According to this theory, a) Make tresses grow breakage oil better because of the when the body efficiently b) Make hair thicker tight coils eliminates waste, the c) Remove split ends 6. Traction alopecia can be b) Curly coils make it difblood is healthier—and caused by… ficult for natural oils to work that means fewer gray 3. Black hair is fragile and a) Tight braids down the hair shaft hairs. People can support prone to breakage… b) Chemical treatments c) Curly textured hair is the process by helping the a) Even when natural c) Hair weaves vulnerable to drying out and b) Only when relaxed breaking body rid itself of waste. c) Only when wet 7. How often should you “Silica is a natural remedy moisturize black hair?

10. Regular scalp massages that cleanses the body by do the following: 4. When it comes to cleansing a) Every other day eliminating waste,” Simontresses, you should... a) Contribute to black hair b) Every day sen explains. “This cell a) Change brands often breakage c) Once a week salt purifies the blood and or else shampoo will stop b) Increase blood circulation enhances digestion. Better working 8. What are the best moistur- to hair follicles digestion leads to healthy izers for black hair? b) Only use products for c) Remove dead skin cells hair, skin and nails.” black hair a) Ingredients that add body that inhibit hair growth But even though an overall healthy lifestyle Answers: 1) b 2) c 3) a 4) c 5) b and c 6) a, b and c 7) b 8) c 9) b and c 10) b and c

(FIRST PAGES: PORTRAIT) DREAMSTIME.COM/SEPRIMORIS

How Much Do You Know About African-American Hair?

SP RIN G 2011 RE A L H E A LTH 3 1

THOUGHTS

Stigma Free After her HIV-positive diagnosis, Tembeni Fazo started a dialogue to end HIV discrimination.

Do you find it painful to stand up for you?

Many people do. But only you can change that.

W

hat is assertiveness? It’s a way to become more direct and less passive. And that doesn’t mean becoming more aggressive and bullying or intimidating others. You can be assertive and still respect the rights, opinions and feelings of others.

But how do you cultivate this communication skill? Start by asking yourself these questions: Do I voice my opinions or remain silent? How do I speak with others? Do I respect people’s right to disagree with me?

To practice being assertive, try these simple exercises: Practice saying no and rehearse what you want to say; use body language to get your point across (adopt a confident posture and lean forward slightly, avoid dramatic gestures, and make non-threatening eye contact); and try to keep your emotions in check.

To complete the exercise, analyze your interactions afterthe-fact by asking yourself these two questions: Was I being direct? Was I being respectful? If the answer to both is yes, then you’re on the right road. Ultimately, being assertive boosts your self-esteem and self-confidence while improving your relationships with others.

Can’t seem to get it right? Assert yourself and get help.

Assertiveness training resources are available online.

—Willette Francis 3 2 R E A L H E A LTH S P R IN G 2011

I

realhealthmag.com

THE EXPERT SAYS What’s the difference between assertiveness and aggression? Assertiveness is about stating, in a calm and clear manner, your preferences, suggestions, agenda and concerns. Aggression, however, generally involves threatening others with a verbal, physical or emotional attack, explains Ramani Durvasula, PhD, a professor of psychology at the University of California at Los Angeles.

You use assertiveness to your advantage when you take charge, handle responsibilities and clearly communicate what you expect of other people—including the consequences if they fail to meet your expectations.

These examples of assertiveness show confidence and leadership.

Conversely, you should resort to aggression only in the most desperate situations, such as when you’re being physically threatened and must defend yourself, Durvasula says. But be cautious.

Why? Because aggression is likely to be met with more aggression, she says. What that means is, you’ll have to be prepared for anything.

—WF

DREAMSTIME.COM/RON CHAPPLE STUDIOS

Assert Yourself

After I was diagnosed with HIV in 2001, the stigma I experienced in my family and community at large made me realize that people were uneducated about HIV/AIDS. They didn’t know what the virus was about. As a result, I felt motivated to educate others about [people living with HIV].

I know that being diagnosed with HIV isn’t something everyone can instantly accept. Through my work at African Services Committee in New York City, I’m able to help people [living with HIV] who have nothing—no family and no friends. My work as a peer educator to other Africans in the community gives people hope. We talk the same language, and we’re all Africans dealing with the same issues.

My work as a community peer educator opens a dialogue where there is none. Once people start talking, communication creates a forward movement and opens a dialogue where there was silence.

When people are quiet, everyone loses because there’s no progress.

When people communicate, everyone airs their fears and we can address them. Talking is a way to empower others to stand up and be heard.

—As told to Willette Francis

READER SURVEY

SPEAK YOUR MIND!

(And Win Free Stuff)

How much do you know about hepatitis C? 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 Billy Blanks Jr. fitness DVD (suggested retail price $14.98), like the one pictured left.

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.

Win this gift now!

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

16. What type of physician or health care provider is/was responsible for managing your hepatitis?

8. Have you ever heard of hepatitis C virus (HCV)?

17. Have you ever had a liver biopsy?

❑ Yes

❑ Yes

❑ No (skip to question 21)

❑ Primary care physician (NOT a specialist) ❑ Infectious disease specialist ❑ Gastroenterologist ❑ Hepatologist ❑ Other: _______________________________

❑ No

❑ Not sure

9. How is hepatitis C transmitted? (Check all that apply.)

18. Do you have liver disease?

❑ Exposure to infected blood in health care settings

❑ Yes

❑ No

❑ Not sure

❑ A mosquito bite ❑ Sharing food with someone infected with HCV

19. Where do you get your hepatitis C information?

(Check all that apply.)

❑ Being born to a mother with HCV

❑ My health care provider

❑ Sharing personal care items, such as razors or toothbrushes

❑ Friends and family

❑ Getting a piercing or tattoo using unsterile equipment

❑ The Internet

❑ Receiving a blood transfusion or organ transplant before 1992

❑ Magazines or books

❑ Having sexual contact with someone infected with HCV

❑ Hepatitis newsletters

❑ Sharing a needle or works to inject drugs

❑ Hepatitis support groups

10. Have you ever been tested for hepatitis C? ❑ Yes

❑ No

❑ A national or local organization

❑ Not sure

20. Do you think there is a cure for hepatitis C? 11. If you have been tested, do you know why?

❑ Yes

❑ No

❑ Not sure

❑ My health care provider suggested I get tested ❑ I received a letter from a blood/tissue donation organization or a

21. What year were you born?_________

public health official saying that I might be infected ❑ I asked to be tested

22. What is your gender?

❑ Other: _______________________________

❑ Female

❑ Male

❑ Transgender

❑ Other

12. If you have not been tested, why not? ❑ I do not believe I am at risk for HCV infection

23. What is your household income?

❑ The test was never offered to me

❑ Under $15,000

❑ I don’t want to be tested

❑ $35,000–$49,999

❑ $50,000–$74,999

❑ Other: _______________________________

❑ $75,000–$99,999

❑ $100,000 and over

13. Are you currently infected with hepatitis C?

24. What is your ethnicity?

❑ Yes

❑ American Indian or Alaska Native

❑ No

❑ $15,000–$34,999

❑ Arab or Middle Eastern

14. How long ago were you diagnosed with hepatitis C?

❑ Asian

❑ Less than 1 year ago

❑ 1 to 5 years ago

❑ Black or African American

❑ 5 to 10 years ago

❑ More than 10 years ago

❑ Hispanic or Latino ❑ Native Hawaiian or other Pacific Islander

15. Have you ever been treated for hepatitis C?

❑ White

❑ Yes

❑ Other

❑ No

Spring 2011