Three lifestyle changes to reduce risk of breast cancer after menopause
Joanna Hayden, PhD, CHES

A report last week from The American Institute for Cancer Research (AICR) and the World Cancer Research Fund based on the results of 119 studies, concluded that three lifestyle behaviors - maintaining a healthy weight, regular exercise and limiting alcohol - can reduce the risk of breast cancer after menopause.                                           
Complete report is at: http://www.aicr.org/continuous-update-project/reports/breast-cancer-report-2017.pdf

Use this news

The risk of breast cancer increases each decade as women age with the greatest incidence of the disease occurring after menopause. Overall, a woman has a 1 in 8 chance of developing breast cancer during  her lifetime.

There are a number of risk factors associated with breast cancer, some that can be controlled and others that cannot. Among the uncontrollable risk factors are those that increase lifetime exposure of breast tissue to the hormones estrogen and progesterone including:

  •   Early menarche - Menstruation beginning before age 12
  • Late menopause – after age 55
  • Never having children
  • First child after age 30

Other uncontrollable risk factors include:

  • Family history – especially first degree relative (mother, sister, daughter)
  • Genetic mutations – BRCA I and BRCA 2

Since there is relatively little we can do to change the uncontrollable risk factors, it makes sense to do all we can to address the controllable risk factors, especially those cited in the report above.

1.        Weight

There is strong, convincing evidence that greater body fatness throughout adulthood (greater BMI, waist-hip ratio, waist circumference) is a cause of post-menopausal breast cancer

There is strong, convincing evidence that greater weight gain in adulthood is a cause of breast cancer.

The AICR recommendations:

o   Keep weight as low as you can within the healthy range.

o   Don’t rely on supplements for cancer prevention –eat a
      healthy diet.

     Avoid high calorie foods and sugary drinks
     Eat more whole grains, vegetables, fruits and beans
     Limit red meat to one pound per week (beef, pork, lamb, etc.)

2.       Alcohol Consumption

There is strong, convincing evidence that alcohol consumption is a cause of post-menopausal breast cancer.

The AICR recommendation:

o   Don’t drink
     For cancer prevention, alcohol should be avoided altogether.

3.      Physical Activity

There is strong evidence that physical activity probably protects against post menopausal breast cancer

The AICR recommendations:

o   Move More
      Aim for 30 minutes of physical activity every day

o   Sit less

The preventative lifestyle changes above don’t negate the need for regular screening for early detection. As a reminder, the American Cancer Society recommends women at average risk of breast cancer begin yearly mammograms at age 45 and switch to every – other year at age 55.

For more information:

National Cancer Institute – Breast Cancer Risk Assessment Tool

American Cancer Society – Breast Cancer


Possible record breaking tick season made worse by Powassan
Joanna Hayden, PhD, CHES

The Centers for Disease Control is expecting this summer to be the worse tick season on record made even more troubling by Powassan, a potentially fatal viral disease transmitted by ticks. 

Summary article: https://medlineplus.gov/news/fullstory_165462.html

Use this news

While there are many benefits to a mild winter including lower heating bills and fewer snow days, one down side is the tick population. Our mild winter allowed more ticks to survive – which means more ticks will be looking for food this spring, summer and fall.  Unfortunately, their meals consist of blood – yours, your children’s, your pets’…they aren’t very picky about the source. And in exchange for feeding them, they sometimes leave you with the bacteria that causes Lyme disease. If you are an unfortunate recipient, antibiotic treatment is effective.

Not so with Powassan, a troubling new viral tick-borne disease.  There are no medications (antibiotics don’t work on viruses) to treat it or  vaccine to prevent infection. More troubling is that since Powassan virus can attack the nervous system, it can cause encephalitis (brain inflammation) and meningitis (inflammation of the membranes around the spinal cord). Although it’s not very common, with a record breaking tick season unfolding, the risk of Powassan transmission is increased.  

According to the CDC, it takes anywhere from about 7 – 30 days after being bitten by a tick carrying the Powassan virus for symptoms to begin, if they occur at all.

Because Powassan virus can infect the central nervous system, symptoms to look for  include:

  • fever
  •  headache
  •  vomiting
  •  weakness
  • confusion
  •  loss of coordination
  •  trouble speaking
  •  seizures
About half of those who survive a Powassan infection have permanent health issues such as recurrent headaches, muscle wasting and memory problems. 

Approximately 10% of people who develop viral encephalitis caused by Powassan virus, die.

Since there is no treatment and a possibility of fatality, the best way to protect you and your family from this or any tick-borne disease is to follow these CDC recommendations:

1.       Avoid contact with ticks
2.       Walk in the center of trails or paths through woods or
           tall grasses

3.      Use repellent:

On exposed skin use repellent with 20% or more DEET, picaridin, or IR3535 on exposed skin for protection that lasts several hours.

On clothing (pants, boots, socks) and gear (tents) use repellant with 0.5% permethrin.

4.      Bathe or take a shower as soon as possible after coming
         indoors (preferably within two hours) to wash off and more
         easily find ticks that are crawling on you.

5.      Check your whole body for ticks and use a mirror to check
         your back, neck,  under the arms, in and around the ears,
         inside the belly button, behind the knees,   between the 
          legs, around the waist, and especially in your hair or on
          your head.

6.     Check pets, coats, backpacks, etc. as ticks can come into the
         house on them and attach to a person later.

7.     Put clothes in a dryer on high heat for 10 minutes to kill          
         ticks on dry clothing.

          If the clothes are damp, additional time may be needed.

          If the clothes need to be washed, wash them in HOT water.
          Cold and medium temperature water will not kill ticks

          For clothes that cannot be washed in hot water, tumble
          dry them for on low heat for 90 minutes or high heat for 60
          minutes. The clothes should be warm and completely dry.

Remember, it takes about 24 hours before a tick begins feeding on your blood, so don’t panic if you find one crawling on your skin.

               Use tweezers to take it off.
               Submerge the live tick in alcohol until it’s dead.
               Then, either flush it down the toilet or put it in a bag,  
                seal it, tape it and put it in the  garbage.

If you find a tick after it has attached, remove it using the following CDC recommended method:

  1. Using a fine-tipped tweezers - grasp the tick as close to the skin's surface as possible.

  2. Pull upward with steady, even pressure. Don't twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.

  3. If the tick is alive submerge it in alcohol to kill it and then placing it in a sealed bag/container, wrapping it tightly in tape, or flush it down the toilet. Never crush a tick with your fingers.

  4. After removing the tick, clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.

 DO NOT use nail polish, nail polish remover, petroleum jelly, gasoline, or the heat from a match to get the tick to detach from the skin. You want to remove it as quickly as possible–not wait for it to “let go.” (https://www.cdc.gov/ticks/).

For more information

Centers for Disease Control and Prevention


Tick removal

Environmental Protection Agency
Find the insect repellant that is right for you

No antibiotics for you!

Joanna Hayden, PhD, CHES

In a study of more than 180,000 people age 66 or older published recently in the Annals of Internal Medicine, almost half (46%) of the people seen by their physicians for a cold, acute bronchitis, sinusitis, or laryngitis were given antibiotics even though none of these are caused by bacteria, which is the only thing antibiotics work on. The likelihood of getting an antibiotic prescription was greatest from physicians in the mid to latter part of their careers, those who received their medical education outside of the U.S. or Canada, and from those who saw more than 25 patients a day.

Journal article abstract: http://annals.org/aim/article/2625386/antibiotic-prescribing-nonbacterial-acute-upper-respiratory-infections-elderly-persons

Article summary: http://www.medicalnewstoday.com/releases/317409.php

Use this News

Why is this important, you ask? Because inappropriate use of antibiotics has unintended consequences, among them: increased health care cost, increased risk of antibiotic resistance, and increased risk of drug induced complications  like allergic reactions and diarrhea - with the most serious of which is caused by Clostridium difficile (C. diff) - which can be fatal.

What can you do to avoid being prescribed antibiotics when you don’t need them? The CDC recommends the following actions:

·        Don’t pressure your health care provider for antibiotics.

·        Ask your health care provider about ways to treat your
          symptoms without antibiotics.

·       Tell your health care provider you are concerned about
         using antibiotics unless they are absolutely necessary to treat
         a bacterial  infection.

·         Practice good hand hygiene to prevent infection in the first

Remember -  taking antibiotics for a viral infection:

Will NOT cure you

Will NOT prevent those around you from getting sick

Will NOT make you feel better

For more information see:

Centers for Disease Control and Prevention
Antibiotics aren’t always the answer

Protecting yourself and your family

About antibiotic use and resistance




One out of five people at risk of a heart attack don’t change their behaviors
Joanna Hayden, PhD, CHES

A study conducted on more than 45,000 people published this week in the Journal of the American Heart Association found that almost 20% of those with at least five out of nine modifiable risk factors for heart disease, didn’t think they needed to make any healthy lifestyle changes.

A summary of the study is at: https://medlineplus.gov/news/fullstory_165183.html

TheComplete journal article: http://jaha.ahajournals.org/content/6/5/e005491

Use this news

First of all, let’s clear up what a risk factor is.  A risk factor is something that increases your chances, i.e. risk, of developing a disease. With all other things being equal, if you have heart disease risk factors, the chances of you developing heart disease or having a heart attack are greater than someone who doesn’t have them.

Heart disease risk factors are broken down into two categories, non-modifiable (not changeable) and modifiable (changeable).   The non-modifiable ones are those things we can’t do anything about – our age, genetics/family history, gender, race.

Modifiable risk factors we can do something about. They are the ones related to our lifestyles and the ones in the research above. There are nine modifiable or controllable risk factors that collectively account for more than 90% of heart attack risk.
They are:
·         smoking

·         high blood pressure

·         diabetes

·         abdominal obesity

·         high stress levels

·         less than five fruits and vegetables a day

·         more than four alcoholic drinks a week

·         physical inactivity

·         elevated lipoprotein levels

Making the lifestyle changes to address these risks can reduce your chances of a heart attack. It means taking responsibility for your health and doing all you can to prevent a heart attack in the first place rather than relying on a bypass or stent after the fact. It’s just like making sure you put gas in your car when it gets low. You don’t want to run out of gas and risk damaging the fuel pump. Yes, the fuel pump can be replaced, but at a cost much greater than simply filling up. 

Albeit, putting gas in your car is a whole lot easier than changing the way you live!  In fact, more than half of the study participants said lack of will power, work schedule, and family responsibilities stopped them from making the changes they knew they should make.

But, any step toward making those changes is better than no step at all. So, to reduce your heart attack risk:

-       Start with one behavior.

Trying to change everything at once is overwhelming and leads to nothing changing
Choose something small for starters – maybe just adding a salad to dinner every night, or walking for 10 minutes after lunch.

-       Be specific and realistic about what you want to accomplish.

I want to lose 20 pounds over the next 5 months (1-2 pounds a week) is specific and realistic.
I want to be a different size by the end of the week - is neither specific nor realistic.  

-       Do some research into the different options for changing the behavior.

If you want to quit smoking you can go cold turkey, use a nicotine patch, take medication and/or get hypnotized.  

Increasing physical activity doesn’t only mean joining a gym, you could walk more for starters.

-       Make preparations for your change.

If you’re going to increase fruit and vegetable intake, you need to buy fruits and vegetables.
If you’re going to try to reduce your stress, it might mean finding a yoga class that meets at a convenient time.

-       Write down one aim or goal for the first week

Make it something you can accomplish –

For example - My aim for this week is to:

o   not drink alcohol on Wednesday

o   have fruit during my coffee break

o   get my clothes ready the night before

-       Pick a change start date.

Once you have everything in place, decide on when you’re going to start the change.

-       Get others around you on board to help.

Don’t try to go it alone. You need all the help you can get from family and friends. Tell people you are quitting smoking, cutting back on drinking, walking more, etc.

-         Remember this is not a quick fix, it's a lifestyle change.

It took you a long time to develop the unhealthy behaviors, it will take time to change them. Keep in mind that change is a process that doesn’t happen overnight. This is not a race, it’s more like a stroll in the park.

For more information see:

Harvard Health Publications

American Psychological Association

Centers for Disease Control – Diabetes Lifestyle Change


Note:  Associates for Health Education and Behavior specializes in lifestyle behavior change for heart disease risk reduction. Working with each client as an ‘associate,’ together we develop a custom behavior change plan that reflects the unique life situation each person brings to the table.