Thursday, February 2, 2017

Why Women May Want to Return to Full-Fat Dairy Products

I remember when we made the switch.
Whole milk, which had been a staple of the American diet for decades, was bad for our hearts, the experts told us. It contained too much fat that could clog our arteries. Other full-fat dairy products, too, like cottage cheese, yogurt, pudding, and cheese also increased risk of heart disease, type 2 diabetes, obesity, and cancer.
Low-fat options were the way to go for good health, they assured us.
So my family replaced our full-fat milk jug with a one-percent milk fat option instead. We also started buying low-fat versions of other dairy products, until buying full-fat seemed an indulgence, at best, and dangerous, at worst.
It was a bit of an adjustment. The products tasted different, more watery. But when you’re talking about your long-term health, you understand that sometimes you need to make sacrifices. And after awhile, we all got used to it.
But recently, there have been some rumblings in the scientific world.
Could it be that they had it all wrong?
Are the full-fat versions of dairy products actually better for us?
Recent Studies Suggest Full-Fat Dairy May Be Healthier
Recent research has examined the relationship between dairy foods and obesity, cardiovascular disease, and type 2 diabetes. Scientists have found surprising results.
In one study review, for example, those who consumed high-fat dairy products were less likely to be obese. They were also no more likely to develop cardiovascular disease or type 2 diabetes than those who ate low-fat dairy products.
“The observational evidence,” the researchers wrote, “does not support the hypothesis that dairy fat or high-fat dairy foods contribute to obesity or cardiometabolic risks, and suggests that high-fat dairy consumption within typical dietary patterns is inversely associated with obesity risk.”
In other words, low-fat dairy doesn’t seem to be any healthier than high-fat dairy, and may actually be less healthy in some ways.
Other studies have shown similar results. Scandinavian researchers followed about 1,500 men aged 40-60 years over a 12-year period. They found that a low intake of dairy fat was actually associated with a higher risk of developing obesity, while a high intake of dairy fat was associated with a lower risk of obesity—the exact opposite of what we’ve been lead to believe would happen.
Seems we could also potentially reduce risk of type 2 diabetes if we ate more full-fat dairy products. In a recent 2016 study, researchers reported that participants with a higher circulating blood level of dairy fat had a 44­–52 percent lower risk of type 2 diabetes than those with a lower blood level of dairy fat.
An earlier 2014 study showed similar results—those who ate the most high-fat dairy products had a 23 percent lower risk of developing type 2 diabetes than those with the lowest consumption. A third study found that eating more high-fat yogurt and cheese could reduce risk of type 2 diabetes by as much as a fifth.
Does Low-Fat Fail to Protect Women from Heart Disease?
Heart disease remains the number-one killer of women, and we’ve all been taught that the best way to avoid it is to cut back on fat. But more recent studies are questioning that logic, too.
In 2016, for instance, scientists reported that a higher fat DASH (Dietary Approaches to Stop Hypertension) diet actually lowered blood pressure the same as the regular DASH diet, but then also reduced triglyceride levels and did not raise LDL “bad” cholesterol levels.
In another 2016 study, researchers looked at data from over 200,000 participants and found no link between high-fat dairy foods and risk of cardiovascular disease. In an earlier review examining the relationship between milk fat and cardiovascular health, researchers found that most studies failed to find a link between the intake of dairy products and an increased risk of cardiovascular disease, coronary heart disease, or stroke.
Does this mean that women can go back to eating full-fat dairy products without having to worry about negative health consequences?
Should Women Be Concerned About Full-Fat Dairy?
There are plenty of reasons for women to be concerned about eating too much fat.
Breast cancer is one of them. In 2013, researchers reported that patients who consumed high-fat dairy products after getting a breast cancer diagnosis were more likely to die from the disease years later. An earlier study also found that intake of animal fat, mainly from red meat and high-fat dairy foods, was associated with an increased risk of breast cancer.
Other studies have linked intake of high-fat dairy products to other types of cancer, like ovarian cancer, but the results have been mixed. Whereas a 2004 study found a link between intakes of dairy products and risk of certain types of ovarian cancer, a 2013 study did not. In fact, in that study, researchers reported that a high intake of calcium (often from dairy products) reduced risk of ovarian cancer.
Results on breast cancer, too, haven’t always been consistent. A pooled analysis from over 20 studies found no link between dairy product intake and breast cancer risk.
Still, the fact that even some studies have found a connection can leave women feeling worried. Even if recent studies show that full-fat dairy products don’t affect heart disease risk and may even protect against obesity and type 2 diabetes, there are those other studies showing the exact opposite.
So what are women supposed to do?
The Whole Fat-Health Connection is More Complicated Than Expected
Here are some things to consider.
When manufacturers began to take the fat out of dairy products, they often replaced it with sugar to make it taste better. That means that while we were getting less fat, we were getting more sugar, which we now know may actually be more harmful when it comes to our health.
Studies have also found that when we eat less fat, we tend to eat more sugar and simple carbohydrates to compensate for the lack of fat in our diets. Both of these are known to increase inflammation—which is linked to heart disease and cancer—and to increase risk of diabetes.
All that sugar also seems to have a more detrimental affect on our weight than fat does. In a 2016 study of over 18,000 women over the age of 45, researchers found that greater intake of high-fat dairy products (but not low-fat dairy products) was associated with less weight gain.
In a review of 39 studies, researchers found that higher intakes of sugar not only increased risk of obesity, but also raised triglyceride levels, increased total cholesterol levels, and increased blood pressure.
The problem is that when experts started telling us to cut out the fat in our diets, they didn’t realize that we’d have resulting cravings that would compel us to replace them with other bad stuff. Scientists failed to take the human diet as a whole into consideration.
The theory now is that maybe, when we eat full-fat dairy products, we don’t feel as many cravings for sugary foods. Fat tends to satisfy. In fact, foods that can make us feel full have been largely ignored until now as being important to our health. Full-fat dairy products are more satisfying than low-fat dairy when it comes to fullness, and that alone could help us to better manage weight and our risk of cardiovascular disease.
You’ve heard the advice to eat more avocadoes, walnuts, flaxseed, and fatty fish, for example. That’s because these foods contain what are called “healthy fats” that we now know can help protect the heart, blood vessels, and brain.
It could be that dairy fats, too, can help improve the way our cells break down sugar from food, which would have an overall positive effect on our health. Certain high-fat dairy foods that are fermented, like yogurt and cheese, can help improve insulin response, which would decrease risk of type 2 diabetes. Fatty acids from dairy foods may play a role in hormone regulation, and may help limit how much fat the body stores.
What About Dairy Products and Hormones?
There’s something else that’s concerning about dairy products, however: hormones.
We know from scientific research that there is a link between cancer and hormones, estrogen in particular. Unfortunately, much of the milk we buy in the store has hormones in it. Cow’s milk, according to Harvard researchers, contains considerable amounts of female sex hormones.
This is because most dairy farms in the U.S. keep their cows pregnant to keep them producing, and milk from pregnant cows contains higher hormone levels than milk from nonpregnant ones.
Since hormones reside in fat, the concern is that full-fat dairy products will have more hormones.
Could this be why some studies have found a link between the consumption of full-fat dairy products and an increased risk of some cancers?
We don’t know for sure yet. Remember that many studies have found no link between dairy products and cancer, and some have even found dairy products to be protective against some cancers. But it is something to keep in mind.
Women Can Feel Good About Adding Some Fat Back Into Their Diets
How do we balance what we know about full-fat dairy and women’s health with what we don’t know?
For now, scientists advise women not to go whole-hog on full-fat dairy, but to consider replacing some of their low-fat items with higher-fat alternatives to try to go for a more well-balanced diet.
You may want to swap your one-percent for whole milk, for example, or choose full-fat yogurt and cottage cheese (since these are fermented products and likely healthier anyway). If eating high-fat dairy options help you eat less sugar and carbs overall, that’s another reason to eat more of them—especially if you find that you lose weight when doing it.
Every woman is different, so your best bet is to experiment a little bit and see what’s best. What you don’t want to do is see fat as the enemy anymore. We have too much evidence showing that it can help protect you against disease. It’s still wise to limit your consumption so you’re not packing on the extra calories, but it might also be smart to add back in a few items you enjoy to see how they affect you.
In addition, look for healthier options that are likely to have fewer hormones. That means products that come from organically raised, grass-fed cows. You may also want to consider raw milk (that hasn’t been pasteurized) in some cases, because it contains healthy enzymes, but do consider the source so you don’t expose yourself (or your family) to dangerous microbes. If you’re at all concerned, go for pasteurized.





Saturday, January 21, 2017

Table Talk: 5 Strategies for Surviving Thanksgiving Get-Togethers

November has been a month of opposites. Many of us have been alternately pleased by the mild weather and consumed with the recent political election. No matter which side of the issues you find yourself on – there is one thing on which we can all agree – we can’t agree on much these days.
And now we find ourselves at Thanksgiving. A time when, for many families, contention may be the norm and awkward is the best one can hope for. But, in true American spirit – you must not despair. The holidays are a time for remembering the things that bring us together – and forgetting for a while the things that tear us apart. And the best gift you can give this holiday season, to yourself and to your loved ones, is a commitment to sane, respectful discourse – and in the absence of that, the benefit of a well-thought out escape plan.
In the hopes that that will not be necessary, here are five more strategies that may help you enjoy the holidays. Remember, ultimately, you actually do love these people.
Strategy 1: Find your allies.
If you are the political renegade in your family – you better buy extra wine. Just kidding. (Not really.) But in addition to that, it’s a great idea to at least find an errant aunt or a jolly grandpa who is willing to agree that the table at least should be a neutral zone. Enlist this person to help you brainstorm a list of safe table conversations – How many new soccer players does the family have this year? Who earned their black belt? Has anyone discovered that they are NOT in fact gluten intolerant? That’s really something to celebrate and provides a whole myriad of conversational tributaries to explore. It’s a rare family dinner where an enthusiastic person with a penchant for diversion cannot entice a whole litany of digestive distraction discussion topics from the other diners. Formalize your alliance as firmly as you can before you sit down at the table, and when you do make eye contact with your allies and give them a little wink, knowing that on this subject at least you can all agree.
Strategy 2: Invite a witness.
Of all the holidays Thanksgiving is most often the one in which we open our homes to others. Can you find a friend or two who might be tempted away from a solitary celebration in order to become the buffer to bad behavior at your holiday meal? Whether it’s your Cousin Nancy who you suspect will toss the first verbal grenade – or perhaps even yourself – having a guest encourages all attendees to be on their best behavior. You will all feel so good about yourselves for the magnanimous inclusion of wayward diners that perhaps no one will feel the need to spill the proverbial gravy boat. One word of advice – if you are planning to use this person (or persons) as a human shield for uncomfortable dinner discussions – it’s best to pick an extroverted type. You might find yourself on Santa’s naughty list if you choose your quiet, introverted co-worker to take one for the team.
Strategy 3: Wear your chic-est comfy pants.
It’s a wise sage (pun intended) who endeavors to be comfortable on our most indulgent holiday. It’s difficult to be charitable when one is feeling pinched – and for this Thanksgiving in particular, you may want to give yourself every advantage. But that isn’t to say that you should show up in sweats – unless of course that’s your thing. There are many ways to dress up an outfit that otherwise might be best suited to the couch. A little jewelry, a little make-up, a cozy sweater that feels like a hug. Whatever you choose to wear, or adorn yourself with, make sure that it makes you feel good. Self-love through style choices should not be overlooked. It’s easier to be forgiving towards others when the waistline of your pants is forgiving towards you. It may seem a small act, but taking the time to ensure that your clothing is comfortable and comforting can potentially make quite a difference when you’re faced with the choice to take someone to task or to take the high road.
Strategy 4: Pick your battles – and your battleground.
For many people this election season has brought up issues that feel vital to their well-being and their personal freedoms. It may feel disingenuous to talk of lighter topics when you feel so much is at stake. It may, in fact, feel impossible. But, try to remember that even if you and your family vastly disagree on these issues it is highly likely that you can agree on how important you feel the stakes are to your respective lives. This article is by no means an entreaty to ignore the very real and disturbing trends that have surfaced in the political scene – or to suggest an ostrich-like approach to our collective societal problems – rather to implore readers to commit to the idea that there are still safe places, places where love is still the language of the day. Our differences may divide us, but if we can remember to set aside time to come together in friendship and fellowship and family, despite our disparities, then we just might make the progress that all of us are looking for.
Strategy 5: Give thanks.
And lastly, when all else fails, find yourself a quiet space to actually feel the gratitude that we are all endeavoring to celebrate on Thanksgiving. Carve out a space and a time to sit quietly before the hustle and bustle of the holiday gets going and do some deep breathing. Quiet contemplation and meditation can soothe the mind and make space for accepting the differences of others. Find some pretty paper and some colorful pens and journal about the things that bring you joy. Use these things, these blessings, these tools – to protect yourself from the worry that comes from heading into uncharted territory. Use your gratitude as a map to find a common humanity with those with whom you viscerally disagree. Cicero said, “Gratitude is not only the greatest of virtues, but the parent of all others.” And who among us does not see the need for more virtue in our lives? Yes, there is still much work to be done – that will always be the case – but there is still much to be grateful for, and this after all, is why we come together.

Celebrating the Holidays

When you are a caregiver for a family member with dementia, the holidays are a mixture of many things: practical organizing and preparations, as well as a jumble of feelings and emotions. It is not uncommon for family caregivers to feel overwhelmed, anxious, or sad, as they look forward to the days ahead. Old traditions may not feel the same. Holiday planning may feel like another chore to get done. We may be faced with the decisions regarding how to include our loved one with dementia in our holiday plans. While we attend to our day-to-day duties it is important to attend to ourselves. This can be annoying advice to hear – maybe you’ve been told this several times already by friends or family. But I think we need continual reminders to do so. Especially since the times we need self-care the most are also the times we find ourselves least able to step away, relax, and take a deep breath. Because the holidays evoke strong feelings and emotions we need reminders and encouragement that it is okay to embrace the days ahead in a manner that is in alignment with our true feelings, experiences, and needs. The following is a guide to the holidays for caregivers that focuses on self-care, as well as finding meaning in new routines adapted to meet the needs of a family member with dementia.
Be kind to yourself.
Don’t judge yourself or set expectations too high. It’s okay to amend holiday rituals or shift how celebrations take place with your family member with dementia. Be compassionate with yourself as you encounter anxiety or painful thoughts and feelings associated with disappointments, grief, or family disagreement. Self-compassion in caregiving is essential year-round and especially during emotionally-fraught holidays. Often caregivers experience feelings of loss with the holidays as it marks the changes in their family member with dementia and ways rituals are carried out. Let your holiday grief be what it is. Only do what you can manage and give yourself permission to be okay with that. In short, again, be kind to yourself. I believe it’s the single most important thing we can do for ourselves as caregivers.
Savor the moment.
If you keep yourself too busy during the holidays, you may leave no time to work on the critical need to allow yourself to be present with new rituals and family gatherings in whatever form that now takes. Don’t over schedule and don’t try to “keep busy” simply to avoid anxiety, pain, or preoccupation with making everything perfect for everyone else but yourself.
Also, one of the biggest lessons one can learn while being with our family member with dementia is to truly be present. Because the present is all we have with a person with memory loss – and actually, everyone in our lives – centering ourselves and truly being with our family members endows meaning and spirit to the role of caregiving. It can foster opportunities to learn a tremendous amount about ourselves, our preoccupations, expectations, and the changing relationships we have with the people we love. Concentrate on what is going on around you right now. Sit with your mother, father or partner, hold hands, and listen to an old holiday hymn or watch a holiday film together. Sing together. Read from a religious text or poem that highlights the holiday spirit or themes from the winter season. Ask your loved one with dementia what their holiday rituals were like when they were children. What food did they eat? Who did the cooking? What presents were received? Be mindful to be with the person in the moment while asking these questions. And avoid asking too many questions in rapid succession. The goal is to intend a connection, not merely retrieve information or test memory. Often, it’s not what we talk about; it’s the manner and spirit of how we interact with the person with dementia that makes all the difference. Be curious and engaged.
You can also look at familiar objects, together, such as an old ornament, menorah, or stockings. You can take time together to savor a favorite holiday treat. These moments offer opportunities for connection and demonstrate that important holiday rituals can still take place. It may be different but no less loving and meaningful.
Receive ongoing support from others.
When friends and family reach out to you during the holidays, accept their support. Let them spend time with you and take some of the responsibilities of preparing for the holidays or caregiving. Don’t feel ashamed by your dependence on others. Instead, revel in the knowledge that others care about you and want to help. If you do not have close friends or family members, write out a list of people or support communities that you can count on; neighbors, people at your place of worship, a caregiver support group or counselor. Seek out people who you can count on for practical assistance with holiday tasks or emotional support.
Let go of the need to stay strong during the holidays.
You do not have to plan a perfect holiday gathering or contain your sadness if you are mourning the loss of tradition or relationship as it had been before your loved one’s diagnosis or further decline. During the holidays it can be very important to express your feelings, happy and sad. Our society teaches us that emotional pain is to be avoided, not embraced. Yet it is only in moving toward our pain, discomfort, or grief and feeling our genuine emotions, that we can truly heal and be present in our lives.
Instead of cooking the entire holiday meal as maybe you’ve done in the past, have a potluck, have the meal catered, or order in. You don’t need to do all the holiday cooking or keep up with your 20 + guest list. Perhaps it makes sense to spread out holiday guests to just a few visiting at a time to reduce the impact of too much stimulation on the person with dementia.
Communicate your wishes.
Gather the strength and courage to tell the people in your life what your wishes are for the holidays.  If you’d like their company but prefer to gather somewhere differently, say so. If you’d like to skip some celebrations, that’s okay. If you’re feeling ambivalent or unsure how to celebrate the holidays, tell them this too. If your family member with dementia has experienced considerable declines or an increase in distressed behavior feel free to communicate this. The more family and friends are able to understand your current situation and feelings, the more likely they may be able to offer support. Your friends and family want to help but may not be sure how they can. You can guide them by being direct. Call or send an email expressing how you would like to see the holiday plans unfold.
Plan for some alone time.
Even if it’s for only 15 minutes. Take a long walk, meditate, pray – do what ever helps to nurture your spirit. Especially if you are grieving the loss of old traditions, roles and relationships, take some time to mourn. Express feelings in a diary or light a candle to mark and honor the changes, gains, and losses in your life. They become the small rituals that nurture and heal.
Be still. Take time out of the holiday hustle and bustle and caregiving role for stillness. Again, even if that’s only for 10 minutes. Meditate.  Allow your body and mind to be still. Concentrate on your breathing- in and out. When your mind begins to wander, return to here and now. If you need help, find a meditation audio recording and use it as a guide.
Focus on Relationships.
It might be helpful to instead of concentrating on everything that you have to do during the holidays, concentrate on for whom you are doing it for. Do you need to make 15 dozen cookies? Perhaps pare down to one special recipe or purchase a favorite pie at a local cafĂ©. Similarly, do you need to buy piles of gifts for multiple family members? Ask yourself “Who do you care about and what would truly be meaningful to them?” Instead of going overboard with gift buying and decorating your home, top to bottom, make a meaningful toast. Prepare a few words before a holiday meal begins. Express your feelings and recollections about the last year. As a caregiver, you invest in and value the importance of relationships and family. Talk about this. Write thoughts down if it helps you feel more comfortable. These are the moments people remember.
Bottom line, focus on the people, not the production of it all. Focus on the relationship with your family member with dementia as it is now while mourning past relationships and roles. There is room for both.
Schedule something that gives you pleasure each day.
It’s hard to look forward to each day when you anticipate anxiety, stress, or feelings of loss with upcoming holidays. Counterbalance the demands of the holiday and caregiving by planning something you enjoy each day. It can be simple. Read, go for a walk, have lunch with a friend – whatever relaxes and brings you comfort and joy.
Don’t take hurtful advice or criticism to heart.
The holidays are a time of family gathering. This can also be a time when well-meaning but unhelpful friends or family members attempt to counsel us about our decisions and roles as caregivers. The effect can sometimes leave us feeling hurt, criticized, and unsupported. This can be additionally upsetting if you are dedicating your time, energy, and love to a family member in the best way you know how. Often people are uncomfortable with aging and dementia and offer advice or suggestions without recognizing the complexity inherent in our roles as caregivers making decisions. Guilt is already a common feeling caregivers struggle with. It can be additionally painful when a family member asks why, for instance, mom couldn’t attend the Christmas Eve present opening. Or alternatively, why you haven’t “just put mom in a nursing home.” Often the most sensitive and thoughtful caregivers are also those most impacted by hurtful suggestions and lack of understanding. Remember that you are doing your best and success cannot be measured based on perfection or lack of issues or problems. Find people who you can count on, who support you, and understand the challenges that arise.
Don’t cancel holiday traditions all together.
Traditions are important because they endure for generations, through good times and bad times. Adapt and alter holiday traditions as life changes instead of cutting them out entirely. Without these meaningful rituals the losses experienced due to dementia will feel even more severe. If your family member cannot attend a holiday event, have a small gathering at their long-term care facility. Rent a family room or simply sit next to them and hold their hand and sing a favorite holiday song. Find out the holiday event schedule at the care facility. You can recreate the essence of the holidays anywhere, at any capacity, when you engage whole-heartedly with the people you love.
Find your hope.
Caregivers can feel overwhelmed, anxious, and whipsawed by the uncertainties that chronic illness brings. This can lead to depression and, in some cases, despair and loss of hope. The holidays may magnify these feelings and if you find yourself in despair, fight to find your hope. Hope is an expectation of a good that is yet to be – that healing can occur, that generative purpose and meaning can be felt and carried out. Spend time in the company of people who truly listen and validate your feelings, happy and sad, and at the same time offer space for you to explore future possibilities and goals even if they can’t be pursued right at this moment.
If you are feeling despair, make a list of things you still look forward to in your life. Make a list of people who are present and who you care about. Make a list of everything that gives you joy. For some people spirituality is a source of meaning and hope, for others art, music, and literature can engage the complexities of life, including, joy, loss, and tragedy, as well as, resilience.
You may find that you are growing emotionally and/or spirituality as a result of your experience as a caregiver. What have you learned in your caregiving role and how has this provided strength or promoted wisdom or resilience? Has your vulnerability or the vulnerability of your family member made you more compassionate? Has it encouraged you to be more comfortable with uncertainty? These questions can function to help recognize how your role now impacts your life and offers growth – even if under the surface and not always recognized. This revelation from French writer Albert Camus offers insight, “In the depth of winter, I finally learned that there was in me an invisible summer.” Recognize your growth and ways painful times have impacted you in profound ways, times when on the surface there appeared no hope – just loss or sacrifice. I think we often perceive that dementia “robs a person” and leaves them “empty shells.” A caregiver once told me, “Alzheimer’s disease impacts the brain, not the heart.” Remember that. A person on the surface may appear to have lost so much but their essential humanness and need and ability to connect is still there in even the most advanced stages. There is hope in this understanding. Keep centering yourself, remain present, let go of expectations and see what happens. And again, the holidays remind us of the joy that can be found in the depths of a barren winter, a time of apparent deprivation. It teaches us to look under the surface and find the beauty that may be hidden but is profoundly still there. When we experience the holidays as an opportunity to take time out to nurture ourselves and engage the values we carry out everyday, it can do wonders to affirm our purpose and the skills, time and attention we give to others.
What you do truly is exceptional.