NEED TO KNOW: New Pap Test Guidelines

New guidelines say you may need fewer pap tests if you’re healthy. But that doesn’t mean you should stop seeing your gyno regularly.

The American College of Obstetricians and Gynecologists have released new guidelines surrounding pap and HPV (human papillomavirus) testing. Their recommendations:

– Women under age 21 are advised to postpone their first pap test until age 21.

-Women ages 21 to 29 that have had a healthy pap test at their last exam can wait three years before their next test.

-Women ages 30 to 65 are advised to request a pap test, as well as a test for the cancer-causing HPV virus. If both of those test results show no signs of trouble, it is recommended they wait five years for their next screening.

During your pap test, a doctor takes a sample of cells from the cervix, which is then sent to a lab for examination. If the sample is abnormal, your doctor may call you back for further testing. Abnormal cells may simply signify a small change in the cervix, but they could also be sign of pre-cancer, caused by a strain of HPV. If left untreated, pre-cancerous cells can develop into cervical cancer.

So why the call for fewer paps? Jennifer Ashton, MD, a New-Jersey based board-certified OBGYN and Fellow of the American College of Obstetricians and Gynecologists, says these new guidelines stem from doctors’ increased understanding of how HPV impacts the body. While virtually all cervical cancer is caused by HPV, the process can take many years to develop. In most cases, the body can clear up the HPV virus on it’s own, and extra testing can put the patient at risk medically, emotionally and financially.

The recommendation for women under age 21 to skip pap tests is due to a high probability of false alarms, Ashton says. Because of the significant incidence of HPV in the teenage population, many of those early pap tests can come out abnormal. As a result, patients are subjected to extra testing, as well as unnecessary extra stress, even though a very small percentage of those abnormalities progress to pre-cancer of the cervix, she says. The same logic applies to the recommendation for fewer tests for women in their 20s.

Women in the 30 to 65 age group need to request an HPV test, because if infected at an early age, the virus has had more time to advance, says Ashton. More importantly, Ashton says women should request the high-risk test specifically. “More than 50 percent of doctors do low-risk HPV testing, which is unjustified, a waste of money, and potentially harmful to the patient,” she says. While pap tests look specifically at the cells of the cervix, high-risk HPV tests look at sign of infection in your DNA, says Ashton. For those reasons, women should make sure they receive both, she says.

Healthy and HPV-free? No need to cancel your gyno appointments just yet. If your lady doc is also your primary care physician, there are still reasons to schedule a yearly visit, says Ashton. “Your doctor can screen for other STDs, make sure you don’t have any problems with your period, check your blood pressure, and monitor breast health,” she says.

Get overwhelmed in the waiting room? Here’s how to get the most out of your next check up.

photo: altrendo images/Stockbyte/Thinkstock

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Do You Really Need an Annual Checkup?

Ever leave your yearly physical feeling like you got absolutely nothing out of the exam? It makes you wonder: What’s the point of an annual checkup anyway?

A group of Danish researchers wondered the same thing, leading them to the conclusion that there is little benefit to routine exams on healthy people.

Study authors analyzed information from 183,000 people who were randomly assigned to either receive a routine health check—involving screening tests, a physical exam, or advice about lifestyle changes—or not receive one.

Results showed patients who received routine health checks were just as likely to die over a nine-year period compared with those who did not receive health checks.

But don’t cancel your annual exam just yet. “It’s more than just a trip to the doctor,” says Robert Wergin, MD, a practicing family physician in Milford, Nebraska, and member of the board of directors of the American Academy of Family Physicians—who is not affiliated with the study. “It’s about establishing a relationship with someone who cares about, and can help you with, your health.” You may not need to see a doctor when you’re healthy, but when you come down with a nasty bug or mysterious ache, you’ll be glad to have someone with a knowledge of your medical history to turn to. Your relationship with your primary care physician, if well established, can provide peace of mind when you’re not feeling your best. “We’re like an extension of your own family,” Wergin adds. “We’re always there for you.”

Not to mention, your doctor recommends medications and lifestyle changes with the sole purpose of preventing you from getting sick in the first place. “Why wait until the event, whether it’s a heart attack or diabetes, to do the intervention?” Wergin asks.

At the end of the day, the amount of times you visit your primary care physician is a matter of personal need and choice, Wergin says. But when you do visit the doc, make the most of your appointment by following these guidelines.

Write down your questions ahead of time
You need a grocery list to help you remember the bok choy for your stir-fry, why not make a reminder note to ask about your neck pain? Primary care physicians “cover your whole health,” Wergin says, so no questions are off limits. From irregular moles to troublesome periods, primary care docs provide you with answers or point you in the right direction.

Discuss age-related milestones
As you age, your health concerns change. Not sure what to ask your doctor? Here is what you should be concerned with in your…20s, 30s, and 40s.

Stay organized with a health journal
When was your last pap smear? How long have you been on the pill? A health journal helps you keep track of this information and more, “keeping your health in the forefront of your mind,” Wergin says. Here is what you should include in your journal:

*Dates of any medical tests
*Illness or injury
*Hospitalizations
*Surgeries
*Allergies
*Medicines, vitamins or supplements that you are taking and how often you take them
*Diseases or illness in your immediate family

photo: Digital Vision/Thinkstock

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Even Your Fat Cells Need Sleep

sleep deprivationNot getting enough sleep can make you groggy, but can it also make you fat? Researchers at the University of Chicago think it’s a strong possibility.

In a new study published in the Annals of Internal Medicine, researchers determined that four nights of sleep deprivation reduced insulin sensitivity in fat cells by a whopping 30 percent. And the less sensitive your cells are to insulin, the less your body produces the hunger-regulating hormone leptin.

“This is one of the first studies to show that a cell outside of the brain—the fat cell—also needs sleep,” says study author Matthew Brady, Ph.D., vice-chair of the Committee on Molecular Metabolism and Nutrition at the University of Chicago.

Brady and a team of researchers put seven young, healthy subjects through two study conditions: First, they spent 8.5 hours in bed for four nights in a row (participants slept for roughly 8 hours each night, the ideal length). One month later, they spent 4.5 hours in bed for four nights. Previous research has shown that getting only 4 hours of sleep negatively affects metabolism. After the fourth night, the subjects took a glucose tolerance test and had fat cells biopsied. And, yes, food intake was controlled and identical.

How Sleep Affects Fat
The authors found that sleep deprivation made fat cells less sensitive to insulin, a hormone that cells use to take in glucose for energy. Brady explains that insulin-stimulated glucose uptake is proportional to the secretion of leptin, a hormone made in the fat cell that regulates hunger.  The less sensitive cells are to insulin, the less leptin they produce, and the hungrier you are. And the magnitude of the decrease in this case was very surprising.

“A 30 percent reduction in insulin sensitivity is equivalent to metabolically aging the subjects 10-20 years just from four nights of four and a half hours of sleep,” Brady says.

“It’s not that we took someone who was on the tipping point of developing metabolic disease and just pushed them over the edge. These were very young, healthy subjects.”

Brady says the findings are important because they suggest that sleep could be a treatment for obesity. To that end, his next study will consist of trying to improve the sleep of overweight or obese subjects who have obstructive sleep apnea to see if sleep quality has any effect on insulin sensitivity and metabolism. He’s excited about the possible impact such a study might have: “It’s hard to get people to diet and exercise but if you could show that improving your sleep quality and duration has a positive benefit, that may be an easier therapeutic intervention for people to undertake.”

Ways to Get Better Sleep
While this study still leaves some questions unanswered—namely, if sleeping, say, 6 hours is bad or if “catching up” on sleep over the weekend can reverse the effects—it’s clear that getting enough sleep is important for both your mind AND your body. Here are five ways you can improve your sleep now.

1. Make a Bedtime Routine
Pick an hour for shutting down every night and stick to it—on weekends, too. A regular bedtime and waking time will help you fall asleep.

2. Power Down
Checking your cell before bed amps up brain activity, making it harder to doze off. Plus, the blue light emitted from gadgets can suppress the sleep hormone melatonin. At least an hour before bedtime, turn off your TV and computer and don’t use your phone.

3. Chill Out
A cooler body makes it easier to fall asleep. Exaggerate that feeling with a toasty, pre-bed bath or shower. Lower your thermostat a bit, then pile on the blankets—you’ll save money on your heat while you’re at it.

4. Sip Wisely
No caffeine after sundown and no booze before bed. While drinking alcohol may help you fall asleep faster, you could wake up in the middle of the night. Enjoy a cup of decaf or herbal tea instead.

5. Drown Out Noise
Sleep with a fan on or invest in a sound machine that can produce white noise to block the racket of the outside world.

Additional reporting by Katie Connor and Loren Chidoni

photo: Stockbyte/Thinkstock

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The One Person You NEED to Unfriend on Facebook

Remove that bookmark to your former flame’s Facebook page. Staying connected to an ex on Facebook can halt your recovery from the breakup and stunt your personal growth, according to a new study in Cyberpsychology, Behavior, and Social Networking.

Researchers asked 464 people to answer questions about a past distressing breakup, including how much time had passed since the split, which partner initiated it, and how much contact they’ve had with their ex since calling it quits.

After crunching the data, researchers found that remaining friends on Facebook actually resulted in less desire, attraction, and longing for the ex. But those who consistently kept tabs on their ex’s page were more likely to feel distressed, lonely, and hung-up on the breakup. (You don’t have to be stuck in a rut forever. Heal your broken heart with this: Yoga Exercises to Get Over a Breakup.)

Ultimately, Facebook isn’t really to blame for your lack of closure. Instead, it’s not having enough self-control—plus a persistent need to seek out information—that leaves you permanently bitter from the breakup, says Tara C. Marshall, Ph.D., lead study author and psychologist at Brunel University in England.

So what’s a girl to do if she can’t nix her addiction to sifting through his pictures and status updates? Unfriend, unfollow, and un . . . whatever it is you do on Instagram. But that’s not enough—you also have to ditch anything that remotely reminds you of him, says Melysha Acharya, founder of BrokenHeartedGirl.com.

“Get rid of that blanket you cuddled together under, move your bed, buy a new bedspread, and rearrange your couch and your flatscreen so the familiar look of your living room doesn’t stir up old memories,” Acharya says.

You heard it here first: The best way to quit your ex is to go cold turkey.

Additional reporting by Denny Watkins

photo: iStockphoto/Thinkstock

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Major Breast Cancer News: What You Need to Know

 
Amazing research alert: There are four genetically distinct classes of breast cancers, according to an article published in the journal Nature. These findings will impact how doctors approach cancer treatment going forward.

“Knowing about the different classes of tumors means doctors can tailor a patient’s therapy so that it’s more individualized,” says Alyssa Gillego, M.D., breast surgeon at Beth Israel Comprehensive Cancer Center in New York City. That means better targeted—read: more accurate, less risky—approaches, depending on your tumor type. (One harmless way to stay on top of your breast health? Take the Touch Yourself Challenge.)

For instance, one class of cancer cells is called Basal-like, or triple-negative. The researchers determined that it genetically resembles a certain type of ovarian cancer. Currently, it’s commonly treated with a class of chemotherapy drugs called Anthracyclines, which are associated with increased risk of heart disease. But knowing that Basal-like cells resemble ovarian cancer cells, which aren’t typically treated with Anthracyclines, researchers can begin to study whether there are alternative ways (with fewer side effects) to treat basal-type cancers.

All that being said, the four genetic differences between breast cancer tumors aren’t exactly breaking news to most cancer specialists. “Women are treated based on these four categories already,” says Gillego.

What makes this study newsworthy, then, isn’t so much the nitty-gritty findings, but that it serves as further evidence to support the need for personalized medicine, an increasingly popular philosophy in patient care. While many doctors now support this philosophy, some still exist who aren’t as up-to-date and prefer to treat patients wholesale, rather than as individuals.

For example, traditionally tumor size has dictated whether a patient receives chemotherapy, says Gillego. “If the tumor was a centimeter in diameter, you automatically got chemotherapy, regardless of genetics. There are people in other parts of the world, and even some parts of this country, who still practice like that.” The problem with this approach, as supported by the study findings, is that chemotherapy doesn’t actually work on all tumors. Some need hormone therapy. Some just need surgery. Some need a combination of all or some of the above. The bottom line, though, is that one size does not fit all when it comes to cancer treatments. And ultimately, the more research that exists that supports the need for genetics-based, individualized treatments, the better for the future of cancer care.

In the meantime, if you find yourself facing a breast cancer diagnosis, Gillego recommends seeking treatment from a breast cancer specialist at a cancer center. Cancer centers tend to have integrated teams, where oncologists, radiologist, surgeons, and other specialists all work together closely. “Integrated teams are better set up to provide patient-centered therapy,” she says. Just what the doctor ordered.

photo: Hemera/Thinkstock

 
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Do You Really Need an Omega-3 Supplement?

Today’s headlines may make you reconsider your daily omega-3 supplement: In a review published in the Journal of the American Medical Association, researchers analyzed 20 studies totaling nearly 69,000 people and found no association between people taking omega-3 supplements and decreased mortality from any cause, as well as cardiac death, sudden death, heart attack or stroke.

But don’t take the results at face value. It’s important to note that the group analyzed in the JAMA study are high-risk heart patients. Expecting fish oil to prevent future heart attacks or strokes in people already vulnerable to them is like expecting a Band-Aid to hold back a gushing wound.

Say you’re already overweight and have diabetes—both big risk factors for heart disease. An omega-3 supplement won’t help you much. “There is no way to take these results and assume they apply to healthy people. Of course fish oil is not a cure. If someone is already falling apart, omega-3s won’t put them back together,” says Alan Aragon, M.S., Men’s Health nutrition advisor.

What about generally healthy people? One study in the American Journal of Clinical Nutrition found that overweight adults taking fish oil improved their HDL cholesterol and artery function more than taking a placebo supplement. Even in healthy, young, normal weight adults, fish oil exerts certain heart-protective benefits—lower levels of triglycerides and higher “good” HDL cholesterol numbers, to name a few. (Don’t think you’re safe from a heart attack just because you’re lean. Read this: How Skinny People Have Fat Hearts.)

This study is one of the many meta-analyses that have come out on fish oil supplements recently, says Aragon. “Some review studies show that there is a positive benefit to fish oil, and others say that there’s insufficient evidence. Right now though, more studies than not are on the beneficial side of the fence,” he says. (Why the conflicting reports? Each review looked at different sets of data and studies.)

Other potential issues: The JAMA study doesn’t consider what type of omega-3 supplement these patients were taking. Some fish oil supplements go through processing that makes the omega-3s less absorbable to the body. Others contain contaminants (like mercury or PCBs), and that could make the supplements less effective, explains Aragon. (Find out whether your supplement label is lying.)

Bottom line? It’s best to get nutrients from whole food sources first. Diets rich in omega-3 fatty acids have been shown to reduce inflammation, decrease triglycerides, and lower blood pressure. (Sick of salmon? Here are 3 Surprising Heart-Healthy Foods.)

If you don’t eat at least two 3.5-ounce servings of fish a week, then it’s a good idea to take a supplement of about one gram of EPA and DHA a day. For the record, Aragon takes fish oil daily. His pick: The Costco Kirkland Signature brand, since it contains the type of omega-3s readily absorbed by the body.  “Looking at the research as a whole, there’s a small heart protective effect from taking fish oil. And for me, that’s worth taking a supplement.” (Which pills should you pop every morning? Gulp down The Top 10 Supplements for Women.)

photo: Photographer Name/Collection Name/Thinkstock

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Everything You Need to Know About Soy

If you bypass tofu at salad bars, skip the meatless dishes at Chinese restaurants, and avoid edamame when you’re out for sushi, well, it’s time to give soy-based foods a second look. “Whole soy foods are a great substitute for meat,”says Christine Gerbstadt, MD, a spokesperson for the Academy of Nutrition and Dietetics. Their healthy protein content makes them a good option even if you’re not one of the growing number of people going “flexitarian,”or opting to eat less meat. Here’s your guide to making this legume a regular and great-tasting part of your diet.

Soy 101
All soy products are made from soybeans, mostly grown here in the United States. You can buy whole soybeans dried or canned, or in the produce section or freezer aisle as edamame, the common name for soybeans picked before they’re fully mature. (Edamame can be purchased either in pods or shelled.)

Beyond whole beans, soy takes on a number of different guises. Roasted soybeans are sold as soy nuts or ground into soy nut butter. Soybeans can be
soaked in water, cooked, and filtered to
make soy milk and soy yogurt. Adding a coagulant to soy milk curdles it, producing tofu, which ranges in texture from “silken”(very soft) to “extra firm,”depending on how
much liquid is removed. Soybeans can also be
fermented into a paste called miso (the base for miso soup) or a cake
or patty called tempeh, which is often used in place of meat in sandwiches or grilled
and eaten on its own. Finally, soy can be found in many packaged foods—such as frozen meatless burgers, cereals, and energy bars—often in the form of “soy protein isolate,”meaning it’s mostly the protein from soybeans you’re getting.

The power of soy
Soy’s biggest nutritional claim to fame is its complete protein, one of the only plant proteins that contains all nine essential amino acids our bodies need from our diets to function properly. This makes it an ideal substitute for meat, poultry, and eggs. In fact, a half cup of cooked soybeans supplies about one-third of your necessary daily protein, for a mere 149 calories (versus about 230 for one serving of cooked ground beef). That protein and the fiber it contains make it incredibly filling. Plus, soybeans are cholesterol-free and lower in heart-unhealthy saturated fat than meat and dairy.


Soy also packs a number of phytochemicals, including isoflavones, which may work together to help fight conditions like cardiovascular disease, osteoporosis, and breast cancer. (Though you might have heard that women with a history of breast cancer should avoid soy, recent research suggests that’s probably not necessary, says Karen Collins, RD, nutrition adviser to the American Institute for Cancer Research.) To score soy’s benefits, get up to three servings a day, mostly from less processed forms like soybeans, soy milk, soy nuts, and tofu. “When soybeans are eaten close to their original state, you get more of their good-for-you attributes,”says Dawn Jackson Blatner, RD, author of The Flexitarian Diet.

You may get slightly more nutrients from fermented soy foods like miso and tempeh, since the fermentation process can make those nutrients more absorbable by the body, says Blatner, but all forms of the legume deserve a place on your plate. Two exceptions: First, avoid soy isoflavone supplement pills and powders. Research hasn’t yet determined how much of it’s safe to take, says Collins. Plus, unlike whole soy foods, they don’t give you the full range of phytochemicals and other nutrients,
such as B vitamins, which help with bodily processes like metabolism and keep your DNA healthy. And though foods made with soy protein isolate (like soy burgers and soy dogs) do usually pack less saturated fat than their meat counterparts, they also tend to be loaded with sodium and additives, so don’t make them a staple.

Easy ways to eat soy
Look for simple places to swap soy in for other foods and drinks. Snack on soy nuts instead of cheese; use soy nut butter instead of peanut butter for a change of pace (you may not be able to tell the difference!). Soy milk is a great alternative for the lactose intolerant (just avoid sweetened ones, which pack extra sugars). Soybeans and tofu take a bit more prep, but not much. Here’s how to make them taste great, fast:

• Steam or boil edamame for 3 to 5 minutes. You can puree them into hummus instead of chickpeas, or just sprinkle the pods with sea salt, chili powder, Chinese five-spice powder, or any other spice you like, and squeeze the beans into your mouth.

• Because it’s so soft, “silken”tofu works well as a thickener for sauces, dips, and smoothies (try our Blueberry-Tofu Smoothie recipe). The denser texture of “firm”or “extra firm”tofu works best for stir-frying, grilling, or baking. Just remove extra moisture first so it’s not mushy: Lay a clean kitchen towel on a cutting board and place tofu on top. Cover with another clean towel and cutting board, then place a heavy pot on top. Allow it to rest for about 1 hour. Cut into cubes or strips and cook. Tofu will soak up the flavor of any dish it’s in; you can also marinate it as you would meat and poultry.

• Prepare whole soybeans the same way you would other beans: Cooked into soups or chili, added to Mexican dishes, or tossed cold in salads, they bring new flavor to your favorite dishes.


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