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Sunday, February 26, 2017

Why Are You Hungry?

Intake of food is the key to survival, and it is no wonder we have a vast array of physiological checks and balances to control how food is consumed, stored, and used in our body. What is a wonder is how the science of this system is both in it's infancy, and not well understood by many scientists nor taught much in medical curriculum yet. Most physicians, even those who treat weight disturbances have therefore never heard of, and do not know how to use knowledge of the molecules that regulate our weight. The list above is just a few of these, here is a quick guide to some of these factors:

1.  Leptin regulates food intake

2. The pituitary gland is controlled by the hypothalamus and this gland has a molecule, PMOC which works through nerve types called Hypothalamic pro-opiomelanocortin (POMC) neurons which regulate energy and glucose metabolism. Leptin appears to work in part through stimulating these as well.

3.  α-melanocyte stimulating hormone (α-MSH) is another hormone of weight control in the brain. Medically it is an anorexigenic factor: causing us eat less and store less body fat.

4.Another important molecule neuropeptide Y (NPY) is found in the brain and it is an "orexigenic" factor, is associated with promoting adipogenesis: fat generation

5. Peptide Yy, a little discussed molecule that is made in the small intestine and helps control our appetite by affecting the pancreas, and the mobility of the gut.

Saturday, February 25, 2017

Normal Weight Is Not the Only Criteria for Fitness: The Obese Normal-Weight Woman

More normal weight women are being diagnosed with Type 2 Diabetes in spite of being normal weight and not seeming to have the traditional risk factors for diabetes. In an article about this condition in the Mayo Clinic Proceedings they looked at the factors that cause the condition they now call the 'metabolically obese normal weight' individual and found that diet was the most important reason individuals find themselves in this condition. The key points in the article were that it is possible to be obese, and have too much body fact and be normal weight,  we have to use alternative definitions for metabolic obesity to identify these patients and help them resolve their condition, because they are at risk for cardiovascular disease. One of the most important points in the article was that abdominal obesity was a more important indicator of risk than overall weight. The two diet strategies they found most helpful were DASH (a heart healthy anti-hypertensive diet), and the HEI diet developed by USDA to be able to track how well an  individual were adhering to the food pyramid. Clinically the obese normal weight woman has more fact, especially internal gut (visceral) fat, higher glucose and cholesterol readings, and impaired sensitivity to insulin. The Mayo clinic group estimates that it is possible that up to 30% of women may have this condition. Laboratory testing, monitoring blood pressure, measuring location of the body fat by accurate body composition studies such as in the DXA, can identify this condition. Modifying your risk factors help to prevent long term disease, and even lower the death rate from this condition. For those women who have not been tested for this condition, we encourage them to have a consultation at Women's Health Practice.

Wednesday, February 22, 2017

Chinese Ring IUD in 3-D Ultrasound

Ring IUD seen in 3-D Ultrasound inside the womb
IUDs come in many varieties, some of which do not have strings, such as this IUD. Since it does not have a string to check the position we can use ultrasound. This ring was developed in Germany by Dr. Ernst Grafenberg. It was originally made of silver, but there was some copper contamination of most of their silver which was felt to help it be effective. Now most are stainless steel, and very few women would ever have an allergic reaction to the metal. The stainless steel was origninally made in Shanghai and this the IUD also is called the 'Shanghai Ring.' Although it is shaped like a small coil which forms a solid ring, when placed in the uterus it conforms to the fundus of the uterus which helps it's effectiveness. It is difficult, but not impossible to remove, and many women will select this device because they plan to no longer have children and it can safely be left in the uterus for 20 years or longer

Tuesday, February 21, 2017

Age of Menopause

The average age of menopause is 51.4 years old. This age does run in families, and anything from 45-55 is normal. The age of menopause is remarkably consistent from culture to culture suggesting that it is not our diet that is responsible. Women who have very late menopause tend to having higher density of bones, very slightly. However, there is an extra 2.8% increase in probability of developing breast cancer for each year menopause is is delayed. For factors that might increase or decrease your personal age of menopause, consider a consultation with your gyno!

Sunday, February 19, 2017

Mastering the Thigh Muscle Prevents Knee Arthritis in Women

General exercise advice is to build as much muscle as you can to make your metabolism rise, and to make you more fit. Being that the thigh muscle is one of our largest (the gluteus muscle of the buttock, and the lats are actually larger), building your thigh muscle strength will give you a lot of return for your workout!. In a recent study from Austria reported in Reuters Health) they showed that if your thigh  are weak you are more likely to develop knee osteoarthritis. so it is very important to your future mobility as well as your future ability to maneuver a soccer ball, lunge for a backhand, or push off the wall in swimming! Study author Dr. Adam Culvenor, a researcher at Paracelsus Medical University in Salzburg, Austria was quoted about the publication in Arthritis Care and Research, February 8 to say "While our recent study has highlighted the important role of strong thigh muscles in reducing the risk of knee osteoarthritis development, particularly in women, it is not possible to guarantee that having strong thigh muscles will protect women from developing knee osteoarthritis because there are many other factors that play into the disease." Squats are the exercise that can build thigh muscles very successfully, but they should be done carefully. Basic squat position and information can be found at WebMD.  Essentially you want to optimize your quadriceps and hamstring strength. Being able to perform the tasks more easily, take stairs more quickly, and generally feeling like getting your step counts is easier can indicate that your exercises are working, but there are other ways to measure the effectiveness of your training with state of the art bone densitometry body composition testing

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Vaginal Contraceptive Ring

If you are a female between the ages of 18 and 35 you may be eligible for a contraceptive ring investigational contraceptive medication study. Qualified participants will receive study-related medical evaluations and care at no cost. If interested, please call 217-356-3736.

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