The Hot Years Magazine - Issue 48

Feel Better, Look Better NOW!

Sleep Tips for Menopause Chronic Fatigue Syndrome ME/CFS How to Keep Your Microbiome Healthy

Gina Carr

Look Better, Feel Better, Balance Your Life

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When Sexual Trauma Happens - Dr. Tracy Kurtzer

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Build Your Core: Squats and Lunges

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The Hot Years

No 48

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My Menopause Magazine

In this Issue: Gina Carr Look Better, Feel Better, Balance Your Life

Sleep Tips for Menopause

Chronic Fatigue Syndrome ME/CFS

How to Keep Your Microbiome Healthy

Build Your Core: Squats and Lunges

Recipe: Banana Bread

When Sexual Trauma Happens

Editorial

The Hot Years

Things You Don’t Talk About (But Need to Know)

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he Hot Years, provides information you need to feel better and have more control over your life, work and relationships.

In this issue, we address impactful topics that are sometimes overlooked, misunderstood, or difficult to talk about. In the feature article, Gina Carr - author, speaker and marketing consultant - discusses her secrets to work- life balance, and strategies she used to overcome weight and health issues.

Dr. Mache wrote an article on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a little-known condition that disproportionately affects women and can mimic menopause. And there’s also a discussion with Jack Gilbert PhD, a researcher in microbial ecology, who demystifies the microbiome and shares how it is impacted by the food you eat. In addition, Dr. Traci Kurtzer,

a gynecologist specializing in sexual trauma, discusses the challenging and sensitive topic of sexual assault.

Need some exercise? Josie Garnier, co-founder of Zumba Gold, shares an exercise video to help you remain active even if you can’t go to the gym. And you’ll find a great recipe as well as other helpful content.

Like all our issues, this issue is focused on taking care of the SUM of you, not just SOME of you. We always welcome your feedback and suggestions for future articles.

Dr. Mache Seibel

Dr. Sharon Seibel

Editor

Associate Editor

Hot Years Featured Article

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Work-Life Balance Secrets

Gina Carr

Work-life has never been easy, but with Covid19, it’s even harder.

Gina Carr, a highly successful entrepreneur, shares her secrets looking better on Zoom, weight loss, and balancing your life

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ina Carr began her career as an engineer who graduated from Georgia Tech and went on to get a Harvard MBA. Since that time she has been a successful serial entrepreneur. She is a host on a web TEDx show; started a membership called Video Rock Starz; and has a private Facebook group called The Healthy Happy Hour. We’re going to address some things I think might be important for you in this crazy time that we live in.

Dr. Mache I want to begin with the digital transformation that happened in 2020 as a result of the Covid-19 pandemic. We now go online for religious services, business events, social gatherings,

Hot Years Featured Article and education. And we’re all expected to be good on camera. Could you offer a few do’s and don’ts for people trying to rock their video presentations?

Gina Carr: A big part of getting comfortable on camera is having things right. I see so many people attending church services and business events virtually now.

They wouldn’t imagine showing up to those events in person wearing their pajamas or sweat pants. And often I see the camera bouncing around, or in their lap, which creates the nose hair shot.

That doesn’t position them for power or for influence or for creating confidence in whoever it is that they’re talking with.

The Hot Years 1. Stabilize your camera. Get it into a position in front of you, at or slightly above eye level. That minimizes double chins. Then you’re looking up just slightly and it’s a more flattering look. A neck scarf is also helpful if you’re worried about a double chin.

2. For women, wear a v-neck; it is usually a more flattering look.

3. Get the lighting on the front of your face, equally distributed so that one side of your face is not darker than the other and they’re pretty evenly lit.

4. Show from about the shoulders up with your head positioned in the top of the camera view like the people do on TV. The chin goes right about mid level on the screen.

5. Avoid a bright light or a bright window or door open behind you or a shadow on your face so people can see your face better and get to know you.

6. Do not do video and drive.

That’s really dangerous for all parties.

7. Avoid green screens. A lot of people love to turn these on. For most people it just looks really weird.

I’m about 50 pounds less than I was just a few years ago when I was on a track for diabetes and heart problems and some very serious health issues.

Some people say, “Well, I’m not going to get any business from there. I don’t really care what they think about me.”

But people judge you; that’s just the way our brains are hardwired. And you at least want them to know, like, and trust you. Here are eight video tips to help you:

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8. Keep the background simple and uncluttered somewhere in your home or office. I have a tapestry behind me that I purchased on Amazon for less than $40 and pinned up to a bookcase.

Because my bookcase is so close to me, people can’t see the bookcase and only see the tapestry. And it allows me to establish a color scheme.

Dr. Mache: Your Facebook private group is called The Healthy Happy Hour. What are you trying to accomplish with that group, particularly for midlife women who are trying to feel and look as good as they can.

Gina: The Healthy Happy Hour group that I have on Facebook was started

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because over the years, I’ve learned a lot about health, and I was amazed at what I learned that was contrary to what I believed was the truth, mainly about diet. I’m about 50 pounds less than I was just a few years ago when I was on a track for diabetes and heart problems and some very serious health issues. And I just knew it was coming. And I had struggled with my weight my entire life.

Dr. Mache: Every five to seven pounds that you lose or gain can improve or worsen both your blood sugar and your blood pressure. It also adds weight on your hip and knee joints. It only takes a little difference to have a big impact.

Hot Years Featured Article Gina: For all those decades I struggled.

Then I went on a juice fast where I was just eating juiced fruits and vegetables.

I lost 20 pounds in 30 days and I felt fantastic. I looked great. I was glowing.

I thought I had to eat animal protein, and a vegan diet was not healthy.

I went plant based, whole food plant based. No packaged foods. I eat fruits and vegetables and whole grains and beans and those kinds of really healthy foods. I feel fantastic. I haven’t had a problem with my weight since, and I know that I have greatly reduced my risk of getting heart disease, cancer, Alzheimer’s, and all kinds of major, chronic, deadly diseases. That’s why I started the group; to share this information that I couldn’t believe wasn’t out there in more abundance.

Dr. Mache: So this is a like-minded group who want to stick with a whole

I think the most important thing is to decide what is important to you, to have boundaries, and to set a schedule, and to stick to that schedule

The Hot Years foods, plant based diet to maintain health and weight control. I’ll confide in you that at age two and a half I was on the front page of the Galveston Daily News, standing on the front steps of the stoop of my parents’ house with one hand in a Cracker Jack box and my belly was sticking out over the pair of shorts I had on.

The caption on the headline of that day’s newspaper was Mighty Mite: The Fattest Kid in the County.

My mother and my two grandmothers were amazing cooks and having lived through the Great Depression, they believed a fat baby is a happy baby.

But I can tell you growing up as a fat kid that a fat baby is not a happy baby.

I’m a strong advocate of plant based diets. But you have to have knowledge of what you’re eating, because you do have to get the right amounts of protein, carbohydrates and fats each day. But if that’s accomplished, it’s a terrific way to maintain weight and stay healthy. How do you add in exercise?

Gina: I watch video classes like Beach Body and OpenFit. Both have excellent classes that I can do. That’s what works best for me. In the old days, I used to go out walking and this time last year I did my first triathlon at 58 years old. And it was my first ever sprint triathlon.

Hot Years Featured Article Dr. Mache: Do you have a schedule?

How do you do it, and how much time do you spend on those classes?

Gina: Typically the classes I’m taking are 30 minutes and I do them every day, except Sundays, at 7:00 AM. I get up early, get some work in, and then I work out. I had to stop thinking of it as a decision. I had to just say, this is what I do. I don’t think about whether I’m gonna take a shower that day.

I don’t think about whether I’m gonna brush my teeth. This is what you do to maintain your health and to be healthy and happy. And it’s critical.

Dr. Mache: I find that’s a good system because what you schedule into the first of the day is generally repeatable. Something always gets in the way later in the day.

The Hot Years easier for your brain. Otherwise you have to decide what kind of clothes you’re gonna wear. And that requires brain power and emotional energy.

Habits are easier than decisions.

Do you have any tips for work life balance? For some people it can be very hard to have work life balance when you work from home because the two are almost confluent.

Gina: I think the most important thing is to decide what is important to you, to have boundaries, and to set a schedule, and to stick to that schedule.

You are the product of the habits that you create. And if your habits include healthy food, exercise at a certain time, etc, you don’t have to think about it. You don’t have to make a decision, because even putting your clothes out the night before makes it

Personally, I do not work from 6:00 PM Saturday until 6:00 PM Sunday. I typically take that time off. It’s sacrosanct.

My partner and I spend the time together on Sundays and Saturday evenings. And we typically do not work.

Similarly at 8:30 every night he and I have a date. We have date night, even if we don’t go anywhere. We sit and talk without any distractions, or watch educational or entertaining videos on YouTube or something like that.

It’s never too late to pursue your dreams and do whatever it takes to achieve that

We use that time to focus on each other. Even though we both work from home and he’s just right around the corner, we typically don’t talk that much during the day because we’re both working. So we check in and I

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The Hot Years Dr. Mache: Well, it seems like you’ve discovered that by having a schedule, both for the relationship things you want to do and the work that you want to do, it makes it possible to get it all done and maintain work-life balance.

Before we conclude, I want to ask you if there is one piece of advice or insight that you would have for women that you think would lift them up or that they would benefit from knowing?

think that it’s critical to have that time. I also don’t start back to work until 8:00 am the next morning.

I get up early and focus on learning to stay up on the latest and greatest in marketing techniques and those kinds of things. Then I exercise, shower, eat breakfast, and work about 12 hours.

But to me, it’s not work. I love it. I’m constantly talking to brilliant people like yourself, who are doing cool things in the world and I’m helping them amplify that message. I enjoy it so much.

Gina: I would say it’s never too late to pursue your dreams. If you are stuck in a relationship or a job or just in a circle of people that you don’t like or who are doing something you don’t like, there are ways to move on. Life is short. Even if your circumstances are dire, there’s so many free tools and access to people around the world that can help you improve and change your circumstances and change your mindset. And so I would just say, pursue your dreams and do whatever it takes to achieve that.

To find more about Gina Carr or how she helps experts get their message out into the world in a bigger way, visit her at GinaCarr.com.

Menopause Quiz:

Your personal menopause assessment

Find out how much your menopause symptoms impact your health, your happiness and your life.

Visit MenopauseQuiz.com to take the free Menopause Quiz.

It only takes a minute, then watch your email for your results and some suggestions on next steps to support you.

Your menopause mentor, Mache Seibel, MD

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The Hot Hot Years Years The My Menopause Magazine

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Tired of Insomnia?

Perimenopause and Sleep

Sleep is one of the biggest challenges in perimenopause.

Here’s why and what you can do about it.

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ccording to the National Sleep Foundation, 61% of midlife women find themselves tossing and turning all night, can’t fall asleep, or wake up multiple times. One major reason is the hormone imbalance due to perimenopause - the four to ten year window leading up to menopause. But a number of other things contribute to poor sleep.

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Most Common Causes of Disturbed Sleep in Perimenopause 1. Hot flashes: Drenching the sheets is no way to drift into slumber 2. Snoring either by you or your spouse: Could be a clue to sleep apnea 3. Nocturia: Getting up to pee multiple times disrupts sleep 4. Restless leg syndrome or leg cramps

Do This to Cruise into Snooze 1. Exercise regularly but not within two hours of bedtime 2. Regular Bedtime: go to bed as close as you can to the same time 3. Dark Room: get rid of the lights; use room darkening shades 4. Stop electronics at least two hours before bedtime 5. Warm bath: treat yourself to a relaxing bath; it also relaxes muscles 6. Cool room: the ideal temperature is between 65°F - 68°F 7. Avoid alcohol and caffeine five hours before bedtime 8. Docking Station: keep a pad and pencil by your bed to write down thoughts so you don’t stay awake trying to remember them 9. Don’t go to bed till you’re tired 10. Listen to relaxing music, meditate or do simple stretches before going to bed to help you relax

5. Room temperature: a warm room makes falling asleep more difficult 6. Stress, Depression or Anxiety: a sad or anxious mind can’t rest The good thing about sleep problems due to perimenopause - it will pass.

But here are some things you can do in the meantime.

Got menopause symptoms? Need a jump start to feel better and more in control? Dr. Mache offers menopausal women struggling with symptoms the information they need to feel better and more in control of their life, work and relationships.

Get the answers you need to feel better – now!

Click the link below and fill in the short form to set up a FREE 15-minute call to find out how to get Dr. Mache’s insights and clear strategies to overcome your most pressing perimenopause and menopause challenges.

Click Here Now!

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The Hot Years

Could Your Menopause Symptoms

be Chronic Fatigue?

ME/CFS is one of those uncommon diseases that you might never have heard about, or never thought would affect you. But it could!

While ME/CFS can affect children over age 11 and men, it most commonly affects women in their 40s.

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hronic Fatigue Syndrome, also known as Myalgic Encephalomyelitis or ME/CFS, is an inflammatory condition that affects between 800,000 and 2.5 million people in the United States, and it’s symptoms can sound a lot like menopause. I was recently interviewed

by Llewellyn King, Executive Producer and Host of “White House Chronicle” on PBS and a person very interested in ME/CFS. This is a summary of our

interview. You can watch the entire interview in the video below.

Though the cause is unknown, what is known is that it is not a psychosomatic illness. And it can be triggered by certain conditions: 1. Viral, bacterial, or parasitic infections 2. Toxin exposure 3. Impaired immunity 4. Inflammatory conditions

Hot Years Here’s what makes it scary: there are no tests to diagnose it and there is no cure available. It’s a diagnosis of exclusion, meaning you have to test for all the other things it could be, and if all that is negative, and you have the Institute of Medicine criteria below, it points to ME/CFS. Criteria for Diagnosing ME/CFS You must have ALL of the following symptoms: • Substantial reduction or impairment in your ability to engage in pre-illness level of activities and fatigue for > 6 months • Post-Exertional Malaise (PEM): It could be either physical or mental activity performed minutes to days before that causes you to feel wiped out • Unrefreshing sleep: you wake up tired Patients must also have at least one of the following symptoms: • Moderate to severe cognitive impairment ≥ 50% of the time • Orthostatic intolerance meaning the development of symptoms when standing upright, which are relieved when reclining It turns out there are a lot of similarities between ME/CFS and menopause.

Compared with women who don’t have it, women with ME/CFS have:

The Hot Years Menstrual bleeding Bleeding between periods Missed periods Hormone use besides Birth Control Pills for conditions like irregular periods, menopause symptoms and bone loss • Gynecologic surgery such as hysterectomy • Pelvic pain and gynecology conditions such as endometriosis, menstrual abnormalities and early menopause • Joint pain, sleep and memory issues that worsen after exertion • Interstitial cystitis, bladder pain syndrome, polycystic ovaries and irritable bowel syndrome • • • •

One study published in the journal Menopause showed that women with ME/CFS have an earlier mean age at menopause onset (37.6 vs 48.6y). This is important because women with early menopause have an increased risk for cardiac disease, Alzheimer’s disease, depression with suicidality, and bone loss - all conditions that can be treated with estrogen therapy.

So if you’re in perimenopause or early menopause and these symptoms sound like you, talk with your healthcare provider about ME/CFS. There are things you could be doing to feel better. For more information visit ME/ CFS Alert on YouTube.

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Gut Matters Understanding Your Microbiome The three pounds of bacteria in our gut, known as the gut microbiome, plays a major role in our health. This discussion will help you understand why and what you can do to keep yours healthy

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f you aren’t familiar with your microbiome, it’s time for you and your gut to have a conversation.

Wait, maybe you have had a conversation and your gut said, “I’m not happy.”

How do you know?

Common symptoms can be gas, bloating, stomach cramps, food allergies, acid reflux, and other digestive issues. Sometimes an imbalanced gut microbiome can contribute to autoimmune diseases like Hashimoto’s Thyroiditis or rheumatoid arthritis, and can even contribute to obesity, mood changes and depression.

Wait, you mean the wrong bacteria in my gut can cause all that?!

Yes it can...and all too often it does!

When the three plus pounds of “good” bacteria in your intestinal tract get out

of balance, it affects your entire body.

They are not just organisms that are in there by accident. They actually reflect a larger genome than all the cells that make up your entire body.

Those micro bacteria are responsible for helping digest your food, regulate your immune system, protect against other bacteria that cause disease, and produce vitamins such as vitamins B12, thiamine and riboflavin, and Vitamin K. They are part of your defense mechanism to help you stay well.

In an effort to get some really important cutting edge information that’s helpful to you, we spoke at the annual meeting of the North American Menopause Society with one of the country’s leading microbiome specialists, Dr. Jack Gilbert, a professor in the Department of Pediatrics and also at the Scripps Institute of Oceanography in San Diego, California.

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Here are his answers to questions about getting in touch with your gut feelings.

Dr. Mache Seibel: What is the microbiome?

Dr. Jack Gilbert: The microbiome is a collection of microbes that include bacteria, fungi, and viruses; any single cell or small living organisms. And it’s the collection of microbes in a particular environment. We are talking about the microbiome of the human gut. But there is a separate microbiome of the vagina and another of the oral cavity.

It’s just a contiguous environment that the microbes live in.

Dr. Mache: How many bacteria are in the gut microbiome?

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Dr. Jack Gilbert: There are approximately 40 trillion bacterial cells and some 500 to a thousand species in the human body. It’s a phenomenal biodiversity, an entire rainforest inside your body.

Dr. Mache: For women who enter perimenopause and menopause, are there any changes that happen just as a course of aging or decreased estrogen?

Dr. Jack Gilbert: We don’t really know the answer to that. Interestingly, while a few studies have been done, they haven’t really been properly controlled. They’ve had very small numbers and therefore lack the rigor to allow us to actually determine if and how the changes that we do observe, actually occur. I would argue that any

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The microbiome is a collection of microbes that include bacteria, fungi, and viruses; any single cell or small living organisms. And it’s the collection of microbes in a particular environment time that you change something in the human body, you’ll have an impact upon the microbes. And the reason for that is, the microbiome is the other side of the coin to the immune system.

And the immune system is affected by everything in the body. If the immune system changes, it will change the microbiome. If the microbiome changes, it changes the immune system.

So you’ve got that constant circular loop between the microbes and the immune system. And hormones have a big impact on the immune system.

Generally, testosterone has an immunosuppressive effect while estrogen has an immune enhancing effect on the immune system.

There are many other feedback loops in the human body that can be altered as we change facets of our lifestyle. And they in turn can influence what microbes can thrive in our body, and which ones die off and are no longer effective. It’s like we’re a dynamic city. And when these new microbes come along or when the economic situation changes, the whole cities ecosystem and infrastructure can be upset and changed, and that’s the same as our body.

Dr. Mache: Women are worried about getting a yeast infection or other things after taking antibiotics. What are your thoughts on that?

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Dr. Jack Gilbert: Well, it depends on if it’s an absorbable antibiotic or nonabsorbable antibiotic, whether you take it orally or whether you take it intravenously. But let’s say it’s a nonabsorbable, orally consumed antibiotic, like gentamicin or vancomycin.

It obviously kills off lots of bacteria living in your intestine, good ones and bad ones. If you change the microbiome, you change the immune system and that propagates effects throughout the body, and affects the metabolites produced by the microbiome in the gut. So you suddenly reduce the concentration of those metabolites and some of them control things like insulin sensitivity or whether you’re hungry or not, or other factors. So it’s incredibly important, but we don’t completely understand all of the potential that that kind of disruption can cause.

Dr. Mache: What about cancer treatments, immune suppression, or stem cell transplants? What happens to the bacteria in the body?

Dr. Jack Gilbert: There’s a lot of interesting work on immunotherapies and the potential to augment their activity by adding bacteria back into the body. We think that the microbiome is the opposite side of the coin to the immune system. And obviously part in parcel of getting cancer, is the fact that your immune system was not able to surveil the upcoming damaged cell and it escaped surveillance.

So could it be, in part, due to your microbiome? We know for example, that when people move from say Japan into a Western lifestyle in Hawaii, their rates of colon cancer, breast cancer, and pancreatic cancer go up signifi-

Hot Years cantly. So it’s the change in lifestyle, not human genetics, which impacts cancer rates. And we think a lot of that can be mediated by the microbiome.

If your microbiome is no longer able to stimulate the immune system in the most appropriate way, it’s entirely feasible that the immune system responses would lead to onset of a lack of surveillance. And that could promote the development of cancer.

By stimulating the immune system, you might theoretically allow the immune system to take on cancer Theoretically by restimulating the immune system, you might actually be able to allow the immune system to take on the cancer. And by adding in things like antibiotics, or like anti PDL1 (PDL1 is a protein that helps keep immune cells from attacking non-harmful cells in the body), we can actually block the cancer’s ability to make itself invisible. We can also promote immune system surveillance by adding in bacteria, which stimulate how the immune system sees. And that double whammy makes it much more likely that the immune system can now clear

The Hot Years out the cancerous cells. Normally, the immune system fights foreign substances like viruses and bacteria, and not your own healthy cells. Some cancer cells have high amounts of PDL1 that allows cancer cells to “trick” the immune system, and avoid being attacked as foreign, harmful substances.

Dr. Mache: So if people go from Japan to Hawaii and suddenly have more colon cancer and pancreatic cancer, is there anything that we could be doing to lower our risk of colon cancer or pancreatic cancer?

Dr. Jack Gilbert: I’m not a clinician and none of my advice should be taken as medical advice. However, the primary thing that we see when people move from one place to another is immune activation. For example, when well people move from India into Australia, the next generation of children, the kids born in Australia, will have a significantly elevated risk of developing food allergies compared to native Australians born in Australia. And I mean native as in the white population. I don’t think any observations have been done on the black population, the actual true natives of Australia.

So what we think is going on there is the immune system of the parents was used to seeing hundreds of different pathogens and had different types of

Hot Years exposures, including environmental exposures, all the time. This new life they have is super clean in Australia, and their children’s immune systems overreact and it causes a problem. It may happen in the first generation, it may happen in the second generation.

But the immune systems are no longer being appropriately stimulated.

Now that could be because there are different types of infections that the Japanese immune system is expecting to see, for example. But it could also be that their diet has changed significantly and we know that diet’s impact upon cancer is huge. One of the ways you might get around that is by increasing and maintaining your consumption of fiber and also other polyphenols. Eat the rainbow. For example, eating a lot of colored fruits and vegetables is generally a recognized way of getting the right kind of phytochemicals into your body, plus eating enough fiber to stimulate the growth of beneficial organisms in your gut. We recommend you try and consume about 50 grams of fiber a day, which is huge.

Dr. Mache: Does it matter which type of fiber?

Dr. Jack Gilbert: Eat the most diverse fiber possible. There are very few forms of fiber that are FDA recognized as having a beneficial impact upon

The Hot Years health. Beta glucan is one of them because it’s been linked explicitly to reduction in cholesterol and maintenance of a healthy heart through clinical studies. However, when it comes to the microbiome, the best thing you can possibly do is eat as many different types of fiber as humanly possible.

Because fiber diversity equates to bacterial diversity and bacterial diversity equates to metabolic diversity and that equates to a beneficial healthy system.

Dr. Mache: What about kids that are born by C-section versus coming through the vaginal canal? They are not exposed to the microenvironment of the mother’s vagina.

Dr. Jack Gilbert: If they come through the vaginal canal, their first immune exposure, the biggest immune exposure is to bacteria in the vagina.

And lactobacillus play a significant role in activating certain primary immune responses early in life.

The hypothesis being, if you went through C-section, you don’t get that.

There are several clinical trials trying to determine if vaginal seeding, where you take the microbes from the vagina and you seed the baby’s body with those bacteria, plays a role in longterm immune health responses. Right now we don’t have any evidence that it does. Some preliminary evidence

Hot Years in animals suggests it might. But you have to wait for the cohorts to grow up to find out.

Dr. Mache: There’s some really fascinating stuff going on now in terms of the area of weight control. I’ve read reports of people who are the obese that are getting samples of stool from thin people placed into their colons and the obese person gets thinner. Can you elaborate on that a little bit?

Dr. Jack Gilbert: The only clinical trial I’m aware of performed in that space, failed to produce massively significant changes. The ones that got fecal material from a thin individual had some weight loss. But we just don’t have the numbers. What we do know is, that if you take fecal material from an obese person, you put it into a mouse, the mouse will have a significant increase in weight gain. So we know that the microbes play a significant role in mediating the host’s metabolic response to food.

We also know that it will take about 9 to 12 months on an anti-obesity diet like a Mediterranean diet, or reducing your caloric intake, to alter the microbiome enough for it to no longer promote obesity in a mouse. So it takes a very long period of time to eradicate those pro-obesity microbes in the gut.

After that they go away and you could

The Hot Years have a better opportunity to control your weight gain.

So we know that certain microbes do promote obesity and by removing them or eradicating them through diet changes, it can play a role in your likelihood of developing obesity.

Dr. Mache: So if people alter their diet and suddenly start eating healthy, it may actually take them nine months before they can actually see the major impact. I’m sure it’s like blowing up a balloon; when you first take your puff, it’s very hard. And then after the first puff you can blow it up easier. And at some point, the weight producing ones become a minority and the weight reducing ones take over.

Dr. Jack Gilbert: It does; ecological succession is a slow process. When people are doing these crazy crash diets they may have an immediate observable effect, but unfortunately, they can’t sustain it because it’s such an extreme dietary regimen. Soon as you go back to your old diet, you lose your progression.

Dr. Mache: How do you shorten that interval of negativity that antibiotics cause?

Dr. Jack Gilbert: Eating a plant rich, diverse fiber diet is the best strategy when you take an antibiotic. But it’s

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not just fiber, it’s also phytochemicals, generally. There’s lots of plant compounds which aren’t fiber, but which are highly important in feeding the right kinds of bacteria. So eat the rainbow. Lots of different colored fruits and vegetables can be helpful.

Dr. Mache: Are there other foods like kimchi and some of the other fermented foods that you really recommend, in addition to just the plants per se?

Dr. Jack Gilbert: We hypothesize that most fermented foods are good

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for you, because your body gets all these different bacterially mediated chemicals, which is then absorbed high up in the gastrointestinal tract, straight after the stomach.

Dr. Mache: What things will knock out your microbiome?

Dr. Jack Gilbert: It’s the things that we all like. Like high sugar or even a sweetner can play a very strong role in promoting the growth of the really pro-inflammatory organisms. Saturated fats is another, like bacon, which I

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Try to eat up to 30 different species of plants a week...Try eating as much raw food as you can...eat as much diversity as you can. really like. Eating out and processed foods have lost a lot of their nutritional content. Remember that nutritional content isn’t only for you; it’s also for the bacteria in your gut.

The best thing you can possibly do is exercise and eat a fiber rich multi-plant

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diet. Try to eat up to 30 different species of plants a week. That could be a fruit, it could lettuce, it could be clover, it could be asparagus. Try eating as much raw food as you can. So I always say eat as much diversity as you can.

Switch it up, go local, go seasonal. And then do light exercise. Take up walking, take up yoga, take up swimming, if you can. Find half an hour just to yourself every single day, and most importantly, focus on your mental health. Take care of your gut and you’ll take care of your mind as well, and you’ll see a dramatic improvement as soon as you eat the right healthy kinds of foods.

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Squats and Lunges to Build Your Core

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Josie Gardiner

hen you’re isolated at home, it can be all too easy to ignore your core strength. So we asked Josie Gardiner, co-founder of Zumba Gold and one of America’s top exercise experts for some tips to keep your core strong.

Here are some exercises that you can do at work or at home in minutes. You can even do them as a warm up for other activities such as golf or tennis. To join Josie in her online exercise classes, visit Praxisperformwell.com.

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Walnut Chocolate Chip

Banana Bread

Here’s a deliciously easy way to put very ripe bananas to good use.

It’s especially heavenly when it’s still warm and the chocolate chips melt in your mouth. Happy eating!

Recipe: Dr. Sharon 2 cups pre sifted all purpose flour 1 teaspoon baking soda 1/4 teaspoon salt 1/2 cup butter or butter substitute 1/2 - 2/3 cup Sugar (I use a monk fruit sweetener) 2 eggs 1 cup mashed ripe bananas (2 bananas) 1/3 cup fat free milk or soy milk 1 teaspoon lemon juice 1/3 cup dark chocolate chips 1/2 cup chopped walnuts

Mix the flour, the baking soda and salt together. Cream the butter and slowly add the sweetener. Mix well. Add the eggs and mashed bananas and blend well. Combine the milk and lemon juice.

Alternately fold in the flour mixture and the milk mixture, starting and ending with the dry mixture, blend well after each addition. Add the chips and nuts and mix well. Pour the batter into a 9 x 5 x 3-inch pan lined with parchment paper. Bake at 350 °F in a preheated oven for about 45 minutes or until a knife inserted into the center comes out clean.

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When

Sexual Trauma Nobody ever deserves to have this happen to them regardless of the circumstances

Traci Kurtzer, MD, NCMP is a physician at the Center for Sexual Medicine and Menopause at Northwestern Medicine in Chicago, where she is the Medical Director of Trauma Informed Care and Education. She provides specialized gynecologic care to patients with a past history of sexual abuse, assault and medical trauma.

Dr. Kurtzer was recently honored as the NAMS Certified Menopause Practitioner (NCMP) of the Year.

The following is from an interview at the NAMS annual meeting.

Happens

Dr. Mache Seibel: Sexual trauma is very uncomfortable to talk about. But if you experience sexual trauma, what are your options? What are you supposed to do?

Dr. Traci Kurtzer: If you are a victim of sexual trauma, the most important thing to remember is that you’re not

You don’t have to do anything you’re not comfortable with

Hot Years alone and you shouldn’t feel like you have to deal with this alone. First and foremost, there are family and friends who can be a support for you; and we really strongly encourage you to seek medical help as well.

The Hot Years I know that many women are really hesitant to go into the hospital because they feel like it’ll be impersonal or they might be blamed for what happened. But really you don’t need to feel that way. We recognize that nobody ever deserves to have this happen to them regardless of the circumstances.

Assault can happen at any age, and prompt evaluation at the emergency department is critical in order for women to have the option for a Not bathing or brushing forensic exam, emergency conyour teeth is ideal. I traception and know that not cleaning access to testing up afterwards can be and treatment to really difficult, but it can reduce the risk for sexually transinterfere with evidence mitted diseases, collection such as HIV. Dr. Mache: What can a woman expect when she goes to the hospital?

Dr. Kurtzer: Here’s what typically will happen if you come into a hospital and have had a sexual assault.

A registered sexual assault nurse or an examiner will meet with you.

You have the right to have an advocate be with you so that you’re not alone during the process. Everything should be very clearly explained and a lot of support should come from the health care team.

So coming in and getting that help is part of that process.

You don’t have to do anything you’re not comfortable with.

You may just report it and get a physical exam to make sure you don’t have any injuries. It may be a decision whether or not you want to proceed with a forensic examination or what is commonly referred to as a rape kit being done. You can then choose to get that report to the police at that time or make a determination to hold off on that. If it’s too difficult to speak about it at that point but you have the report, then there’s always opportunities to reach out to the police later.

Dr. Mache Seibel: If it were a perfect world, who would you tell? Who

Hot Years

should you tell? How do you go about saying it? And if you go into the hospital, how do you phrase it at the front desk?

Dr. Traci Kurtzer: I think anybody that you feel safe with in your personal life can accompany you. That might be a friend, a parent, a sibling. Once you come into the hospital, it’s just a matter of checking in. It’s usually an emergency room setting, and just informing the staff there that you just experienced a sexual assault. They’ll very promptly get you into a private room and as quickly as possible get it taken care of.

Ideally during that time, not bathing or brushing your teeth is ideal. I know that not cleaning up afterwards can be really difficult, but it can interfere with evidence collection, if you decide to go that route. Keeping clothing that you’ve worn and not getting rid of it or washing it is important, too. Now, if it’s after the fact a number of days, or weeks later, or months later, you can always talk to your gynecologist or your primary care physician.

Dr. Mache: It’s never too late to say something?

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It’s never too late to come and seek help and get resources and testing done Dr. Kurtzer: No. It’s never too late to come and seek help and get resources and testing done, so do it whenever you feel like you’re ready to do that. We encourage as soon as possible just so you have the option to have some evidence collection done, but it’s really whenever you feel like you are ready to talk about it and get some help.

Things like this are never ever the fault of the person who had the assault happen to them and you should never feel guilty or like you were responsible in any way. Just come get help and support. You’re not alone.

For immediate help you can call the National Sexual Assault Hotline 1-800-656-4673 (HOPE). You’ll to be routed to a local sexual assault service provider in your area. Trained staff can provide confidential support.

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Chiseled Away E ver heard the expression less is more? A few nights ago, I had a dream. It was about one of Michelangelo’s quotes, “I saw the angel in the marble and carved until I set him free.” Then in my mind’s eye, I saw a block of marble, and beside it was a mallet and a chisel.

I decided to carve a statue of me.

But where to begin? Since I’ve never carved anything before, I wasn’t sure of where or even how to start. So I picked up the chisel in my left hand, placed its blade against the cold, smooth marble, and with the mallet began to hit the chisel.

things I knew I could do, if I worked a little harder before I started. I gently rounded the rough edges of my personality, tapped away, anxiety, smoothed a chip on my shoulder, and with a blow of my mallet removed a nagging fear that was based on a long past experience, not on any recent experiences, which are quite to the contrary. I continued removing areas that needed improving - negative thoughts, self criticisms, past failures.

Unlike Michelangelo, I wasn’t sure I could see the angel in the marble as he put it. What should I keep? What should I chisel away? Then I began to see the block of marble in a different way. Instead of chiseling away the parts of the marble that would shape my physical self, I began to understand that the task in my dream was to remove the parts of my emotional self that I’d like to improve.

When I was satisfied, I laid down the mallet and chisel and sanded a few remaining rough spots. Then I polished my new self. What was remarkable to me was the fact that the statue I had created looked exactly like me. Oh, I looked the same, but I felt different.

More confident, more satisfied, more at peace. It became clear that my goal had not been to add new qualities. It was in fact to remove those qualities that didn’t serve me. And removing things I didn’t like about myself I could see, polish, and focus on things I did like about myself. I could carve away until I set myself free.

I began hammering away doubts that prevented me from accomplishing

What things can you chisel away to feel better about you?

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I like the night.

Without the dark, we’d never see the stars.

Stephenie Meyer, Twilight

CLICK HERE to hear The Sandman, from From my Lullabies for Kids of All Ages CD, written by Dr. Mache and piano performed by Ben Schwendener. You can find this song and other health songs at www.HealthRock.Bandcamp.com.

Every effort has been made to ensure that the information contained in this magazine is complete and accurate. However, neither the publisher nor the author(s) is engaged in rendering professional advice or services to the individual reader. The ideas, procedures, and suggestions contained in this magazine are educational and not intended as a substitute for consulting with your physician. All matters regarding health require medical supervision. Neither the authors nor the publisher shall be liable or responsible for any loss, injury, or damage allegedly arising from any information or suggestion in this magazine. The opinions expressed in this magazine represent personal views of the author(s) and are not a substitute for medical care.

All content in this magazine is Copyright © HealthRock, LLC

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