Are You Addicted To Food? 6 Steps Out Of Food Addiction

Is it time to step up to the plate (so to speak), take an honest and courageous look at your life, and make a commitment to loving yourself? Are you ready to let go of belief systems and habits that no longer serve you? Are you ready to step into a healthier 2010?

Is your weight stopping you from moving forward? Might you be a food addict? Please take an honest look at the following questions and answer, 'yes' or 'no.'

1. Do you find that you have no 'stopping mechanism' and even though you want to 'stop' eating, you can't?

2. Are you obsessed with food? Think about food all the time? And your weight too?

3. Have you attempted one diet plan after another, with no lasting success?

4. Do you binge and/or purge?

5. Do you eat in secret? Are you a closet eater?

6. Are you an emotional eater? Do you use food to escape your feelings?

7. Do you eat even when you are not hungry?

8. Do you eat and then exercise excessively to burn it off?

9. Do you eat, and then feel shame or guilt for about the foods you've just eaten, and then beat yourself up for doing so?

10. Have you put your life on hold until you lose weight? Do you say, "When I lose weight, then I will _________?"

What do you think? Are you a food addict? And if yes, are you ready to do something about it now? If not now, when?

Since it all starts with our thoughts, here are
6 Steps Toward Healthy Thinking! A good start!

Step 1: The Truth. Keep it honest. When we tell the truth, we unleash the forces of positive change. Being in denial, coming up with excuses, rationalizations and untruths may feel like it's working in the short run, but it comes with a great cost. It limits the possibility of change.

Step 2: Be Aware of Your Thoughts. The first step to being in control of your eating habit patterns is to begin to be aware of your thoughts and gain control of your mind. That's right ... you are controlling your mind. No one else!

Step 3: Commit. Commitment is about pledging, promising, taking a vow. It's about being loyal, dedicated, having allegiance to and faith in oneself.

I never thought I'd be quoting football coaches, but as football legend Bill Parcell's points out, "Commitment is about giving your all to every play. It's about choosing the right path; not the easiest one."

Step 4: Practice Awareness/Mindful Eating. Although many of us are intellectually aware of what 'consciousness' refers to, we have not yet made the leap that integrates this type of awareness into our own mouths! In order for 'consciousness' to permeate our lives, we need to experience it (as opposed to intellectualizing it).

Step 5: Seek Support. No man is an island unto himself. Ask for help from friends, family, and/or support groups! Join the Kick in the Tush Club!

Step 6: Motivate Daily. Zig Ziglar said it best, "People often say that motivation doesn't last. Well, neither does bathing - that's why we recommend it daily." Stand in front of the mirror each and every day and remind yourself that you can do it!

By Janice Taylor

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2-Minute tricks that beat stress

The next time you’re having a bad day (or week or month) take heart: you can perk up your mood quickly and simply. According to experts, life circumstances account for only 10% of happiness. Half depends on your genetic “set point,” which is kind of like the weight your body bounces back to after a crash diet. And about 40% of your happiness is influenced by what you do deliberately to make yourself. Here are a few easy tricks to try:

1. Flip through Old Photos
When you’re feeling down, break out your kids’ baby albums or pics from your favorite vacation. It may actually make you feel happier than a square of chocolate would! That’s what researchers at the United Kingdom’s Open University found after they examined how much people’s moods rose after eating a chocolate snack, sipping an alcoholic drink, watching TV, listening to music, or looking at personal photos.

The music and chocolate left most people’s moods unchanged; alcohol and TV gave a slight lift (1%), but the winner by a long shot was viewing pictures, which made people feel 11% better. To keep your spirits high at work, upload your favorite pics to your computer and set them as a rotating screensaver. Or splurge on a frame that flips through digital photos; amazon.com has plenty of options at a wide range of prices.

2. Munch on Nuts
Or sneak salmon into your salad for lunch. They’re both packed with omega-3 fats, which may make people less prone to depression—and easier to get along with, say researchers from the University of Pittsburgh. They measured the blood levels of omega-3 fats (a reliable indicator of consumption) of 106 healthy adults and gave them psychological tests. Those with the highest omega-3 blood levels scored 49 to 58% better on the tests than those with the lowest blood levels.

3. Inhale a Calming Scent
In an Austrian study, researchers wafted the smell of oranges before some participants and lavender before others. The two groups felt less anxious, more positive, and calmer when compared with participants who were exposed no fragrance at all. Add a few drops of either oil to a room diffuser (we like the Scentball, available at amazon.com) and use in your office on stressful days.

4. Open Your Shades
To feel happier in seconds, let the sunlight stream in when you first wake up. One study of more than 450 women found that those who got the most light, particularly in the morning, reported better moods and sleep. Got more time? Eat breakfast near a window that gets plenty of daylight, and put exercise equipment near a bright view. Some researchers speculate that combining exercise with morning light exposure may amplify light’s beneficial effects on mood, sleep, and alertness, says Anthony Levitt, MD, a University of Toronto light researcher.

5. Clear Away Clutter
For some, “clutter is a reminder of things that should be getting done but aren’t,” says Elaine Aron, PhD, author of The Highly Sensitive Person. “It can make you feel like a failure.” For a quick fix, straighten up a few surfaces in your office or in the areas of the house where you spend the most time. “It’s when every bit of space is messy that it’s most disturbing,” says Aron. Don’t bother to organize unless you have a chunk of time. Instead, arrange papers, books, and other detritus of daily living in neat piles or store them in baskets. “Just the illusion of order is enough to ease the mind,” she says.

6. Think Fast
Turn your thoughts into a race—it can lift the blues in minutes, says Princeton University psychologist Emily Pronin, PhD. For example, when your mother-in-law is driving you crazy, give yourself 30 seconds to make a list of all the ways she’s been helpful to you in the past—you’ll feel better fast. (If nothing nice comes to mind, quickly jot down other ways she bugs you; speed thinking negative thoughts can still improve your mood, Pronin found.) Researchers believe that rapid thinking may release feel-good brain chemicals—or it could just be a helpful distraction.

7. Cue Up YouTube
Stanford University researchers literally saw this on fMRI scans, where they traced changes in brain activity to a region called the nucleus accumbens (NAcc), which rewards behaviors such as eating and sex (and laughing) by releasing dopamine, a natural opiate. When stress builds up or you feel as though you may snap at any minute, make yourself giggle: Watch a funny video clip online, or stop by the office of a wisecracking pal for a quick chat.

8. Put On a Happy Face
Studies show that even muscular changes in your face can elevate your happiness, as can good posture, says Lyubomirsky. Call it the blush effect: To apply blush to your cheekbones properly, you need to smile. Smiling works, she says, because “if you act like you’re a happier person, you can experience all these positive social consequences. You make more friends. People are nicer to you. And these things can have real consequences.”

by Liz Vaccariello, Editor-in-Chief, PREVENTION

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V-Shape Shortcuts

Prep for a spring show-off by working your upper body.

By the Editors of Men's Health

If you're going to work your vanity muscles (nothing wrong with that!), choose exercises that provide fast results. This routine uses overhand, underhand, and neutral grips, which combine to demand more of your biceps and triceps. Also, the multimuscle moves will build your chest, back, and shoulders, says Matt McGorry, C.F.T., who created the routine. (And if you want to ignite new growth, be sure you work these six muscles you ignore—but shouldn't.)

1. Bench press

Lie on a flat bench. Using an overhand, shoulder-width grip, hold a barbell straight above your sternum, lower it, pause, and press it back up. Keep your elbows tucked so that when you're in the down position, your upper arms form a 45-degree angle to your body.

2. Chinup

Hang from a chinup bar using an underhand, shoulder-width grip. Pull your chest to the bar. Once the top of your chest touches the bar, pause, and then slowly lower yourself.

If chinups are too hard, try a pulldown machine instead, and use an underhand grip.

(Not seeing the results you want from your workout? Try these eight weightlifting fixes for more muscle.)

3. Seated dumbbell shoulder press

Sit at the end of a bench with your torso upright. Hold a pair of dumbbells just outside your shoulders with your palms facing each other. Press the weights up until your arms are straight, and then slowly lower them to the starting position.

4. Barbell row

Grab a barbell with an overhand grip that's just beyond shoulder width. Keeping your back naturally arched, bend at your hips and knees and lower your torso so it's almost parallel to the floor. Let the bar hang, and then pull it toward your upper abs. Pause, and slowly lower the bar.

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Posted in: Fitness,Muscle Building

6 Muscles You Can't Ignore

By: Ted Spiker

Where would we be without our supporting cast? Peyton Manning wouldn't have time to throw, captains would be swabbing their own decks, and the Dunder Mifflin paper company's brainstorming meetings wouldn't be considered entertainment. Success typically depends on behind-the-scenes help, and your body is no different. While your abs and biceps receive all the glory, here's a secret: It's the little-known muscles that make the big ones stand out. The problem is, working the muscles you can't see—like the ones deep inside your core, hips, and shoulders—can be a difficult process. But target those areas, and your whole body benefits. Not only will you look better, but you'll also have more strength and suffer fewer injuries.

These six muscles may never earn top billing, but they may rejuvenate your workouts and ignite new growth.

Supraspinatus and Subscapularis

Know them: The supraspinatus is one of the small muscles at the top of your shoulder that makes up the rotator cuff; the subscapularis is a large muscle on the front of your shoulder blade. Blame your desk job for weak shoulders: If your upper body is rounded, it's most likely because your chest is tight, which means the opposing muscles in your shoulders are weak. Strengthen the stabilizing muscles, and you'll see improvement on your bench press and in overhead sports like swimming or tennis, as well as in your overall upper-body power.

Test them: Bring your arms straight out in front of you at about a 45-degree angle, your thumbs pointed up—like you're about to hug someone. Have a friend stand in front of you and push your arms downward with moderate pressure. (The friend's hands should be positioned above your wrists on your forearms.) If you feel soreness in your shoulders or can't resist the pressure, you probably need to strengthen your supraspinatus, Plasschaert says.

Improve them: "A lot of people think they need to work the rotator muscles like crazy," says Scott. But a simple move is all you need, says Robertson. Stand holding a light pair of dumbbells in front of your thighs, palms facing each other. Keeping your thumbs pointed up, raise your arms up at a 30-degree angle to your torso until just above shoulder height. Hold for 1 second, and lower to the starting position. Do 2 sets of 8 to 10 repetitions. The exercise will help you add pounds to your bench by improving the stability of your shoulders.

Tensor Fasciae Latae

Know it: This muscle (also known as the TFL) starts along the outer edge of your hip and can affect lateral movement (abduction), which is movement away from your body. A tight TFL can mean you're at increased risk for lateral knee pain, because it attaches directly to your ilio-tibial band--tissue that runs vertically along the outsides of your thighs to help stabilize your knees. Weak or tight abductors means you're constantly getting beat off the dribble, or you're late getting to the ball on the tennis court.

Test it: Try old-fashioned leg lifts. Lie on your side with your legs straight, and raise your top leg to about a 40-degree angle. Then lower it. You should be able to lift your leg in a straight line, without your hip or thigh moving forward, says Jeff Plasschaert, C.S.C.S., a strength coach based in Gainesville, Florida. Make sure you're using hip strength, though; many people substitute motion from their core and lower back to finish the movement.

Improve it: Stretching the TFL is the secret to improving your performance, say Robertson. To stretch your left TFL, stand with your left hip adjacent to a wall. Cross your right foot in front of your left foot. From this position, contract your core and left glute, and then push directly into your left hip. Don't let your hips move backward, and instead make sure your left hip pushes to the side. Hold for 20 to 30 seconds, and then switch legs so your other side faces the wall. Perform 2 or 3 reps on each leg every day.

Psoas

Know it: The psoas (so-az) muscle runs through your hips to connect the lower portion of your back to the top of your thigh. It's one of your body's main back stabilizers and hip flexors (the muscles that line your hips and allow you to bring your knees toward your chest). If you sit all day, the psoas becomes rounded like a banana; then, when you stand up, the psoas pulls on your back, making you more prone to pain and lower-back injury. "A weak psoas also means you'll end up with assorted knee issues, because other secondary hip flexors take over and cause pain," Robertson says.

Test it: Lie on your back and pull one knee to your chest. Keep your other leg straight. If the psoas is of normal length, your straight leg will rest on the floor. If your leg sits above the floor, your psoas is either stiff or shortened, says Bill Hartman, C.S.C.S., a strength coach based in Indianapolis.

Improve it: The only way to strengthen a weak psoas is by bringing your knee above 90 degrees. Sit with your knees bent on a low box or bench (6 to 10 inches high) (3). Maintaining good posture and keeping your abs tight, use your hips to raise one bent knee slightly higher than your hips. If you lean forward or backward, you're not performing the exercise correctly. Hold for 5 seconds, and return to the starting position. Complete 3 sets of 5 repetitions per leg. Also, to help release some of the pressure you may feel, use your thumb to press on your hip flexor; it'll be on your side and a little lower than your belly button.

Piriformis

Know it: This muscle near your gluteal (butt) region helps with thigh rotation and tends to suffer from overuse. Why? Because weak hamstrings and glutes force the piriformis to take on some of the work those big muscles should be doing, says Keith Scott, C.S.C.S., a strength coach based in New Jersey. This creates back and hip pain, and weaker lower-body performance.

Test it: Sit on a chair and cross one leg over the other, with the crossing ankle of one leg resting on the bent knee of the other. If you can't get your top leg parallel to the ground, your piriformis is probably tight.

Improve it: Increase your mobility with windshield wipers, says Robertson: Lie on your back with your knees bent and your feet placed wider than shoulder-width apart on the ground. Press your knees together, and then return to the starting position. Do 2 sets of 10 to 15 repetitions. Now add some soft-tissue work: Sit on a foam roller with your weight shifted to your right butt, and place your right ankle on your left knee. Roll your right glutes from top to bottom, working any painful areas. Continue for 45 to 60 seconds, and switch sides. Do this daily.

Serratus Anterior

Know it: This muscle, located on the side of your chest along your ribs, attaches to and allows you to rotate your shoulder blade (a.k.a. scapula). It plays a vital role when you raise your shoulder to flex your arm and move it away from your body; that's why it's prominent in boxers but not your average guy. The reason? Blame the bench press. Because of the support provided by the bench, the serratus anterior doesn't receive much direct challenge during this popular exercise, says Mike Robertson, C.S.C.S., a strength coach in Indianapolis.

Test it: Do a pushup without wearing a shirt and have someone look at your back during the move. If you have a winged scapula, your shoulder blade will stick out; this means your serratus is weak, says Robertson. A strong one suctions your scapula in during the movement, eliminating the winged look.

Improve it: Standard pushups strengthen the muscle, but doing pushup variations is the quickest way to correct a weakness, says Robertson. Use a power rack to perform incline pushups on a barbell. Start with your body at the lowest incline that doesn't allow your shoulders to wing—which means placing the bar relatively high. Perform 3 sets of 8 to 12 repetitions. As you become stronger and learn to control your scapular motion, work your way down the rack until you're doing regular pushups with perfect body alignment.

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Posted in: Fitness,Muscle Building

7 Reasons You're Still Overweight and How to Get Slim Fast

Why do some people pack on the pounds effortlessly? It’s not always genetics and it’s not always gluttony, and you can’t always blame it on lack of exercise. Indeed, becoming overweight is often a result of some simple—and easily correctible—bad habits, especially when it comes to dining out.

As we began researching Eat This, Not That! Restaurant Survival Guide, we discovered plenty of egregious examples of super-fattening foods in both America’s supermarkets and our chain restaurants. And we learned that if you simply know what to order and what to avoid, you can shave off pounds effortlessly. For example, does On the Border really need to stuff more than a day’s worth of calories into its Dos XX Fish Tacos? (Remember when fish was healthy?) And shouldn’t Chili’s warn parents when a selection on its kids’ menu comes with 82 grams of fat, like its Pepper Pals Little Chicken Crispers does?

If you know these secrets, the power to eat what you want and still stay slim is in your hands. That's why we created the Eat This, Not That! iPhone app! It’s like having your own personal nutritionist at your fingertips.

In the meantime, here’s the hard truth: There's more contributing to America's obesity problem than just fattening food. The restaurant industry has spent decades studying human behavior and figuring out all sorts of subliminal ways to make us want to order and eat more. And a lot of those psychological tricks have become ingrained in our behavior.

In a study in the journal Obesity, researchers looked at the habits of people dining at an all-you-can-eat buffet. Those with the highest body mass index (BMI)—a measure of obesity—shared many of the behaviors listed below. Know them so you can take charge of your waistline—and your health.

#1. Overweight people use larger plates.
When offered two plate sizes, 98.6 percent of those with the highest BMI took the larger of the two plates to the buffet. A bigger plate tricks your eye into thinking you’re not eating as much when you stuff more food onto the surface—and into your mouth. Use a smaller plate, get a smaller belly.

Bonus tip: The same principle holds true for drinks, as we've found while researching the upcoming Drink This, Not That! The larger the cup, the bigger your gut. Check out our list of The 20 Worst Drinks in America and The 40 Best and Worst Beers for two eye-opening lineups of belt-busting beverages that'll drown your diet aspirations. (It's baffling that some drinks can pack more than 2000 calories!)

#2. Overweight people eat while looking at food.
Of those with high BMIs, 41.7 percent took seats that overlooked the buffet, instead of sitting in a booth or facing in a different direction. The sight of food tends to make our minds think we have more work to do, eating-wise. Keep your food stored in the fridge or stashed in the pantry, not out on the countertops.

#3. Overweight people eat with maximum efficiency.
While Chinese buffets offer chopsticks, 91.3 percent of obese patrons opt for forks. That just makes it easier to shovel in the food.

Bonus tip: For simple steps to live a longer and healthier life, read through Dr. Oz's 25 Greatest Health Tips Ever. His tips will dramatically improve your life.

#4. Overweight people clean their plates.
Of those patrons who were the heaviest, 94 percent cleaned their plates so there was nothing left. Ignore Mom’s advice—let a little linger, or take it to go.

#5. Overweight people chew less.
Researchers actually monitored the chewing habits of the buffet-goers and discovered that the heaviest one-third among them chewed their food an average of 11.9 times before swallowing. The middle one-third chewed an average of 14 times, and the leanest one-third chewed 14.8 times.

Bonus tip: Whatever you do, don't chew on these 20 Worst Restaurant Foods in America. Some of these secret meals pack days' worth of salt, sugar, trans-fat and saturated fat! Learn exactly which ones so you can steer clear.

#6. Overweight people dive in.
The leanest people in the study typically took a lap around the buffet first, to plot out what they wanted to eat. But the more overweight group charged right in; doing so means you may fill up on some less-appealing items, then have to go back to snag that one nosh you have to have but missed the first time.

#7. Overweight people skip breakfast.
A simple habit, but missing this crucial meal raises your risk of obesity by a whopping 450 percent! Start your day with some lean protein and fiber—which will jumpstart your metabolism and keep you full. (An egg sandwich is actually a great choice.)

Bonus tip: Save calories, time, and money with the FREE Eat This, Not That! newsletter. Sign up today and you’ll get the Eat This, Not That! guide to shopping once and eating for a week for free.

Article by David Zinczenko, with Matt Goulding

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Should I use hormone replacement therapy (HRT)?

Introduction
Over the past decades, menopausal women have been encouraged to use hormone replacement therapy (HRT) for its apparent health- and youth-preserving benefits. It is true that HRT lowers the risk of osteoporosis and possibly colon cancer. But, compared to women not taking hormones, women taking HRT have slightly higher rates of breast cancer, ovarian cancer, heart attack, stroke, blood clots, and Alzheimer's disease as well as other forms of dementia.

Although HRT risks are not high for most women, on average, the small risks outweigh the small benefits. As a result, women's health experts now recommend that, for most women, HRT use should be limited to one or both of the following:

• Short-term menopausal symptom relief.
• Severe osteoporosis risk (when nonhormonal treatments have been considered and/or tried first).

This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.

Key points in making your decision
Consider the following when deciding whether to start or continue taking hormone replacement therapy (HRT):

• The risks of short-term HRT use are small but significant, particularly for women with preexisting risk factors.
• After 1 year's use, HRT is linked to changes on mammograms in 40 out of 1,000 women. These changes aren't diagnosed as cancer but require further testing.
• After 5 years' use, HRT is linked to breast cancer in 4 to 6 out of 1,000 women. This risk increases with prolonged HRT use.
• The risk of blood clots in the legs or lungs is greatest during the first 2 years, affecting about 6 out of 1,000 women.
• Heart disease is the number one killer of women, and HRT use causes heart disease in a small number of women.
• Heart risk from HRT does not seem to affect women in their first 10 years after menopause. Review your personal heart risk profile versus possible HRT benefits as part of your treatment decision process.
• For perimenopausal symptoms, consider non-HRT treatments, including breathing-for-relaxation exercises; certain antidepressants, low blood pressure medicines, and black cohosh for hot flashes; and vaginal lubricant or vaginal estrogen (cream, ring, or tablet) for dryness and irritation.
• If you decide to use HRT for symptom relief, use the lowest effective dose for the shortest possible time, and see your doctor regularly to reevaluate your personal benefits and risks.
• HRT helps prevent bone loss and osteoporosis. If you are at high risk for osteoporosis, HRT is one of several treatments you can consider.

Medical Information

What is menopause?
After several years of fluctuating hormone levels and irregular menstruation in your 40s or 50s, your estrogen and progesterone levels begin to decline. After 6 months to 1 year of decline, your estrogen level drops past a certain point, and your menstrual cycle ends. Menopause is the point in time when you've had no menstrual periods for 1 year.

During the first year or so after menopause (postmenopause), estrogen levels continue to decline, which can cause perimenopausal symptoms like hot flashes and insomnia or make them worse. After your hormone levels reach a stable low point, these symptoms are likely to subside. This typically takes 1 to 2 years. But some women continue with symptoms for years, perhaps because their estrogen levels are lower than average.

Low estrogen is part of the healthy, natural state of the postmenopausal phase of life—it is tailored to the way your body is meant to function after your childbearing years. Low estrogen is good for you in the sense that it lowers your hormone-related cancer risk. But because estrogen also plays an important role in skin and bone health, low estrogen creates some health concerns for the postmenopausal woman.

• Following years of gradual decline in bone density and strength, low estrogen after menopause speeds up bone loss, which increases your risk of osteoporosis.
• Low estrogen leads to low collagen, a building block of skin and connective tissue. As a result, the vaginal lining and the lower urinary tract also thin and weaken. This condition, called genitourinary atrophy, can make sexual relations difficult and can increase the risk of vaginal and urinary tract infection.

What other treatments are available for perimenopausal symptoms?
Although the perimenopausal transition itself is a natural body change that doesn't require treatment, severe symptoms can disrupt a woman's life and sense of well-being. The first and best approach to reducing your perimenopausal symptoms (and long-term health risks related to aging) is to lead a healthy lifestyle—avoid excess caffeine, alcohol, and stress; eat well; and exercise regularly.

If you need additional relief, you have several non-HRT treatment options to choose from. Slow, rhythmic breathing exercises may help you manage hot flashes and emotional symptoms. Vaginal lubricants (such as Astroglide or K-Y Jelly) are useful for vaginal dryness, and vaginal estrogen (cream, ring, or tablet) can help with vaginal dryness and irritation. Certain types of antidepressants or blood pressure medication (clonidine) may reduce hot flashes. Black cohosh may help with hot flashes and other hormone-related symptoms.

Before menopause, you can also consider low-dose estrogen-progestin birth control pills for perimenopausal symptoms and pregnancy prevention, as long as you have no risk factors for heart disease or breast cancer and you do not smoke.

What is hormone replacement therapy?
Estrogen replacement therapy (ERT) refers to the daily use of estrogen to increase a woman's hormones to premenopausal levels. Women with a uterus who take estrogen also need the hormone progestin to prevent the estrogen from affecting the uterine lining (endometrium), which can lead to endometrial cancer. The combination of estrogen and progestin is called hormone replacement therapy (HRT). Women with a uterus take HRT. Women who have had a hysterectomy to remove the uterus take ERT.

The U.S. Food and Drug Administration (FDA) has updated its HRT recommendations and now only approves estrogen-progestin HRT for:

• Short-term treatment of perimenopausal symptoms. Women who do decide that HRT benefits outweigh their risks are advised to use the lowest effective dose for as short a time as possible, not exceeding 3 or 4 years.
• Osteoporosis prevention and treatment, in select, severe cases. Most experts recommend that HRT only be considered for women with significant risk of osteoporosis that outweighs their risks from taking HRT.10 Women are now encouraged to consider all possible osteoporosis treatments and to compare their risks and benefits.

The FDA is reviewing its ERT recommendations, based on March 2004 stroke risk information from the Women's Health Initiative ERT study. Other low-dose ERT research is currently in progress.

What are the benefits of taking estrogen?
When taken as ERT or HRT, estrogen:

• Helps prevent osteoporosis after menopause by slowing bone loss and promoting some increase in bone density.
• Reduces hot flashes and sleep problems in most, but not all, women.
• Maintains the lining of the vagina, reducing irritation.
• Maintains skin collagen levels, which decline as estrogen levels decline. Collagen is responsible for the stretch in skin and muscle.
• Increases the amount of HDL (“good”) cholesterol and decreases the amount of LDL (“bad”) cholesterol in the blood.
• Reduces the risk of dental problems, such as tooth loss and gum disease.
• May reduce the risk of colon cancer.

What are the risks of hormone replacement therapy?
HRT increases the risks of breast cancer, ovarian cancer, blood clots, heart disease, stroke, and dementia. Estrogen alone (ERT) is also linked to increased stroke, ovarian cancer, dementia, and possible breast cancer risk. No particular form or dosage of ERT or HRT has been proved safer than another.

Among the women using HRT in the recent Women's Health Initiative trials, most did not develop major health problems. But after the first 1 to 4 years of using HRT, a small yet significant number of women did develop signs of cancer, blood clots, heart disease, stroke, and dementia.

• Within the first 2 years, HRT use slightly increased the risk of blood clots in the lungs (pulmonary embolism) and legs (deep vein thrombosis) in all healthy postmenopausal women regardless of risk factors.
• During the second year, HRT use began to slightly increase heart attack and stroke risk in all healthy postmenopausal women, regardless of risk factors. Early signs of heart disease first became apparent during the first year of use. Heart disease risk does not increase for women in the first 10 years after menopause.
• After 1 year, HRT use increased the number of abnormal mammograms by approximately 4% each year. Daily estrogen-progestin increased breast density compared with estrogen alone or placebo. Although the abnormal mammograms required additional medical evaluation, they were not linked to an early increase in breast cancer. Studies are ongoing to learn more about breast density change from HRT.
• After 4 years of use, HRT-related breast cancers first became apparent. The number of HRT-related breast cancers increased with each additional year of HRT use. Women taking HRT generally had larger, more advanced tumors than women who developed breast cancer while taking a placebo treatment. (But some of these cancers may respond more favorably to treatment.)
• After 4 years, HRT use slightly increased the incidence of Alzheimer’s disease and other dementias in women ages 65 and older. HRT does not provide protection from dementia or cognitive impairment, as was previously believed. (Most of the women in this study started HRT several years after menopause, when Alzheimer's risk naturally increases. So, experts do not yet know whether the effect of HRT on Alzheimer's risk is the same for younger women who use short-term HRT starting at menopause.) An HRT-related increase in dementia has been observed in women older than 65.

Your risks. It is impossible to know whether you will develop health problems from HRT. If you have no personal or family history of breast cancer, ovarian cancer, heart attack, stroke, blood clots, and dementia, your increased HRT risks are likely to be small. If you have a personal or family history of breast cancer, ovarian cancer, or heart disease, your HRT risks are likely to be higher than average, making the risks outweigh the benefits. If you have had breast cancer, which can be triggered or made worse by estrogen, taking HRT is not safe for you.

Low-dose HRT. The typical HRT dose is 0.625 mg of estrogen plus 2.5 mg of progestin. In March 2003, the FDA approved a low-dose version of Prempro, containing 0.3 mg of estrogen and 1.5 mg of progestin. This low-dose version may help hot flashes and bone density and is hoped to reduce the risks related to higher-dose HRT, but it needs more study.

Low-dose estrogen for osteoporosis. Researchers are studying the effects of low-dose estrogen therapy. A small early study has shown that a low estrogen dose—0.25 mg per day—may keep the bones as strong as the higher dose. But the long-term risks of taking low-dose estrogen are not yet known.

How and when do I stop taking hormone replacement therapy?
There is no way of knowing in advance whether you will have perimenopausal symptoms when you stop using HRT (or ERT). While some women have no symptoms, others are mildly affected, and some have moderate to severe symptoms. Most women find that their symptoms subside over time.

How to stop HRT. There are currently no evidence-based guidelines for stopping HRT. Talk to your doctor about how you should stop HRT. Your doctor may want you to stop HRT right away or try tapering off. You may taper off by lowering your daily dose, increasing the time between dosages, or trimming back an estrogen patch over time.

When to stop HRT. Ultimately, it is up to you and your doctor to decide how long you will take HRT. After weighing the risks, some women will continue to take HRT for years to come, while others stop as soon as they learn of the risks. If you have been taking HRT for many years, talk to your doctor about stopping HRT.

There are currently no evidence-based guidelines for when to stop short-term HRT. But based on the risks, HRT use for 4 or more years is considered "long term."

If you develop symptoms when tapering or suddenly stopping HRT, consider how severe your symptoms are, what other treatment options are available for symptom relief, and how long you've been taking HRT. You can:

• Slightly increase your HRT dose until symptoms subside. After another 6 months to 1 year, try to taper off again.
• Continue with your plan to stop HRT and see whether symptoms subside over a few months.
• Continue with your plan to stop HRT and try another type of treatment.

If you need more information, see the topic Menopause and Perimenopause.

Your Information
If you have decided that you are in need of symptom treatment after menopause or that you need to treat or prevent osteoporosis, your choices are:

• Use another treatment for perimenopausal symptoms or osteoporosis prevention.
• Use low-dose hormone replacement therapy for the shortest time possible.

The decision about whether to take hormone replacement therapy takes into account your personal feelings and the medical facts.

Making a decision about HRT

Reasons to take HRT

• Low-dose, short-term HRT (up to 4 years). You have no risk factors for heart disease, blood clots, stroke, or breast or ovarian cancer, are willing to accept the small increase in risks of cancer and heart disease, and you:
  
  1. Have considered or tried other treatments.
  2. Have moderate to severe perimenopausal symptoms that are disrupting your sleep and/or daily life.
• Long-term HRT. You are willing to accept the breast and ovarian cancer, blood clot, heart disease, and possible dementia risks of continuing HRT for longer than 4 years, and you:
  
  1. Are at high risk for osteoporosis and have considered or tried other osteoporosis therapies.
  2. Have long-standing perimenopausal symptoms (such as hot flashes) that only HRT will relieve.

Are there other reasons you might want to take hormone replacement therapy?

Reasons to not take HRT

• You have not considered or tried other treatment options.
• You are concerned about blood clot and stroke risk.
• You are 10 or more years past menopause and are concerned about heart disease risk.
• You have been taking HRT for longer than 4 years and are concerned about increased cancer and dementia risks.
• You only have vaginal or urinary tract symptoms, which can be treated with vaginal estrogen (cream, ring, or tablet).
• You need a preventive treatment for heart disease or stroke (HRT does not prevent these conditions).

Do not use HRT if you have:

• A personal history of breast cancer, ovarian cancer, or endometrial cancer.
• A personal history of pulmonary embolism, deep vein thrombosis, heart attack, or stroke. (Your risks may also be higher if you have a family history of these conditions.)
• Vaginal bleeding from an unknown cause.
• Active liver disease (oral estrogen stresses the liver; an estrogen patch or cream does not).

Are there other reasons you might not want to take hormone replacement therapy?

These personal stories about deciding whether to take HRT may help you make your decision.

Wise Health Decision
Answer these questions with Yes/No/Unsure, to help you make your decision. After completing it, you should have a better idea of how you feel about hormone replacement therapy (HRT). Discuss the answers with your doctor.

1. I have tried other perimenopausal treatment options.
2. I can consider using low-dose birth control pills because I have not yet reached menopause.
3. I am in my 50s and consider my cancer, heart disease, and dementia risks to be low.
4. I have a high osteoporosis risk.
5. I have a personal or family history of heart attack, stroke, blood clots in the lungs or legs, or breast or ovarian cancer.
6. I have unbearable perimenopausal symptoms that other therapies cannot control.
7. I think I would take HRT for as long as I need relief from bothersome symptoms.
8. I have been taking HRT for more than 4 years.
9. I would consider taking HRT, but only for a short period of time.

What is your overall impression?
Your answers in the above questions are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to use or not use hormone replacement therapy.
Article by Robin Parks, MS

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90 seconds to slim

Tired of countless sets and reps? Make "one and done" your workout mantra. With this get-lean routine you'll do each move only once, which will leave you twice as much time to enjoy your sleek new physique!

Slow down to firm up. You can tone all over with a single rep. The key? Stretch out each exercise over a full 90 seconds. "Stop-and-hold training is more effective than traditional strength training because it maximizes muscle tension throughout the total range of motion," says Pete Cerqua, author of The 90-Second Fitness Solution (Atria Books), who created these slow-mo moves exclusively for SELF.

You'll need A pair of 5- to 10-pound weights and a stability ball

You'll do One rep (or one on each side) of each sculptor twice a week on nonconsecutive days. Go with the slow!

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