Monday, February 26, 2024

Elevating Women's Wellbeing at Work

Insights from the US Surgeon General's Report
Written by: Joyce Gregory, MD



Promoting the mental health and wellbeing of women in the workplace remains paramount in today’s dynamic post COVID pandemic work landscape. Work plays a pivotal role in shaping the health, wealth, and overall wellbeing of women. Ideally, work provides women with the means to support themselves and their families while also offering a sense of purpose, opportunities for growth, and a supportive community. When women thrive in the workplace, they are more likely to experience both physical and mental wellness, contributing positively to their work environments.

Despite facing challenges like economic disparities, educational debts, and housing instability, organizations have the power to support women's mental health and wellbeing. Leaders and employees can rethink the role of work in women's lives and explore strategies to better support their needs. By prioritizing women's health and happiness at work, organizations can create environments where women can thrive both personally and professionally.

The US Surgeon General's 2022 report on Workplace Mental Health and Well-being offers a comprehensive framework that outlines five essential components designed to meet the unique needs of women in the workforce. Let's explore how these essentials can cultivate workplaces that prioritize women's well-being and professional growth.

Ensuring Protection from Harm
Prioritizing workplace safety is critical, particularly for women who may face heightened risks due to various factors such as discrimination and violence. Organizations must diligently adhere to regulations, improve policies, and collaborate with female employees to ensure a safe work environment.

Adequate rest is essential for the physical and mental well-being of women in the workplace while insufficient rest can lead to increased risks of injuries and burnout. Workplace leaders should consider factors like working hours and provide opportunities for rest to support the well-being and productivity of female employees.

Supporting mental health is crucial, especially for women, to combat stigma and foster inclusive cultures. Organizations can achieve this by providing training, enhancing Employee Assistance Programs (EAP), and ensuring comprehensive healthcare coverage.

Fostering Connection & Community
Fostering a sense of belonging in the workplace is paramount, particularly for women. Encouraging social interaction and breaking down barriers can cultivate positive relationships and shield against bias. Leaders must strive to create inclusive environments where every woman feels empowered to voice her thoughts.

Building trust among female colleagues is key. Leaders should facilitate opportunities for team members to bond, fostering empathy and support, particularly during challenging times. Strong workplace relationships not only enhance performance but also drive innovation, highlighting the importance of transparent communication.

In today's remote or hybrid work setups, promoting collaboration is essential. Leaders should advocate for teamwork, facilitate regular communication, and provide effective collaboration tools. Addressing broader social issues can further strengthen bonds among women, fostering a supportive environment.

Striking Work-Life Harmony
Achieving work-life balance is a common challenge, yet crucial for women's well-being. Granting women autonomy over their work methods and providing flexibility in tasks, schedules, and locations can mitigate conflicts and build trust. Implementing family-friendly policies and respecting boundaries between work and personal time are also essential.

Embracing Mattering at Work
Recognizing the contributions of women in the workplace is vital for fostering a sense of belonging and purpose. This involves providing fair compensation, engaging women in decision-making processes, fostering gratitude and recognition, and aligning individual work with the organizational mission. Empowering women enhances morale and organizational commitment.

Nurturing Opportunity for Growth
Providing women with opportunities for growth and learning is paramount. Companies should offer quality training, education, mentoring programs, and clear pathways for career advancement. Ensuring equitable distribution of opportunities and offering relevant feedback are essential for women's career development and fulfillment.

In the post-pandemic era, workplaces have a unique chance to prioritize women's mental health and well-being, fostering resilience and success. The Surgeon General’s 2022 Framework for Workplace Mental Health & Well-Being serves as a roadmap for creating supportive environments. Sustainable change requires dedicated leadership that amplifies the voices of women. I encourage you to explore the full report to gain deeper insights into fostering women's wellbeing in the workplace and creating inclusive environments for all.



 

Thursday, January 25, 2024

IMAGE GUIDED UTERINE FIBROID TREATMENT

By Dr. Robert L. Bard

Historically, the detection of pelvic tumors is linked to the current state of diagnostic technology.  Critical is the differentiation of benign pathology of the uterine/ovarian complex from malignancies. [1]

According to the Society for Women's Health Research, Over 20,000 women will be diagnosed with ovarian cancer this year in the United States and women have a 92% chance of surviving for five years post-diagnosis. However, more than three-fourths of women are not diagnosed until later stages." [2] Abnormal ovaries are often benign simple cysts, however the complex cysts are classifiable with the new ultrasound scoring system as to how suspicious they may be. The same way we detect prostate tumors by routine yearly ultrasound screening in high risk patients, we could save many lives because sometimes the first sign of ovarian cancer is a gland in the neck that pops up, a mass under the arm or jaundice because the liver is filled with metastatic tumor.

EVOLUTION IN DIAGNOSTICS
In 1980, I gave a talk for the American College of Obstetricians at Memorial Sloan Kettering Cancer Center where we presented the use of real-time imaging for the instantaneous documentation of the fetal heart beat by intrauterine cardiac sonogram to detect fetal demise instead of waiting 2 weeks to see if the fetus was growing. We asserted a similar use of ultrasound technology to monitor abnormal ovarian cysts as small as two centimeters (2-3 cm is about the size of a normal ovary). Early cancers could not be felt, but are imaged with ultrasound as the technology advanced. With today's high resolution and 3D imaging, (including endo probes with elastography for the uterus and ovaries) recent upgrades offer even better capabilities to conduct regular screening in real time called a noninvasive “virtual biopsy”. Ultrasound technology is now able to see three millimeter cancers in the glands and Doppler with Elastography shows activity and fibrosis.

Thanks to modern endo probes that can scan deeper organs, we study micrometastatic nodules throughout the body in superficial areas like lymph nodes and in deeper areas like the ovary. The endo probe resolution is 5x greater than the MRI or the CT scanner.  It is able to see not only the size, location and irregularity in the fibroid mass  it quantitively measures the blood flow, which gives you a number of the abnormal vessels supporting tissue growth.  This same group of imaging devices validates treatment effect since fewer feeding blood vessels implies less aggression. Important distinction between size and activity is that sometimes masses outgrow their blood supply and fill with fluid as they die-cystic internal necrosis of fibroids is common and fortunately diagnosed non invasively.

TREATMENT OPTIONS
While most fibroids involute with patient aging, a small nodule blocking the ureter produces kidney damage. Standard ultrasound testing routinely checks for hydronephrosis of the renal organs as a dilated kidney is a call for surgery.   From our early work with prostate embolization we have adapted uterine artery embolization so that it is acceptable as minimally invasive treatment for women. [3]  Recent adoption of PEMF and NIR Laser (red light treatment) has non invasively provided pain relief and diminished feeding blood vessels with fibroid size and symptom reduction. [4]

(1)-Hassani/Bard Gynecologic Ultrasound   SpringerHeidelberg 1978  (2)-"Ovarian Cancer: Outdated Diagnostics for a Deadly Disease" Society for Women's Health Research 2020. https://swhr.org/ovarian-cancer-outdated-diagnostics-for-a-deadly-disease/ (3)-Awad M etal PEMF in Primary Dysmenorrhea  2020 MJCU 88;2165-2175 (4)-Thabet A etal High intensity Laser vs PEMF in Dysmenorrhea  J Phys Ther Sci 2017 10:1742-1748




Uterine Fibroids: New Approaches to an Underdiagnosed Health Issue

Written and produced by: Dr. Roberta Kline for the Women's Health Digest / Balance & Longevity educational seminar series.


FIBROIDS are the most common tumor of the female pelvis and are the number one reason for hysterectomy. While prevalence estimates vary widely, in part due to systemic underdiagnosis, they range worldwide from 4-70%. Globally, Black women have the highest rate, often 3x that of White women. In addition, Black women are more likely to have more severe symptoms and undergo hysterectomy at an earlier age, adding the burden of lost fertility for these women.  The economic burden is also enormous. It is estimated that fibroids contribute to up to $34 billion in direct and indirect healthcare costs every year. [1] 


NEED MORE ATTENTION TO THIS COMMON WOMEN'S DISORDER
For many decades, the understanding of causes and effective treatments has progressed slowly. With the acceleration of technology enabling molecular and genetic expression research and advanced non-invasive treatment, that is starting to change.


WHAT ARE FIBROIDS?

Fibroids are classified based on where they occur in the uterus. 

Uterine fibroids, also known as uterine leiomyomas, are benign growths within the uterine wall that are made up of the same smooth muscle tissue as normal myometrium. But for reasons that are still not fully understood, they form into 3-dimensional spheres rather than the linear, elongated pattern of normal tissue. 

Up to half of all women with fibroids are symptomatic. Although fibroids are typically benign, they can cause significant health effects. The most common symptoms are painful periods and heavy menstrual bleeding. Pelvic pressure and pain during intercourse are not uncommon. Depending on their size and location, fibroids can press on nerves and cause pain; obstruct nearby organs including ureters, bladder, and intestines. Fibroids can also cause reproductive problems including infertility, recurrent pregnancy loss, and other complications of pregnancy.

WHAT CAUSES FIBROIDS?
Fibroids occur after the onset of menses, and typically shrink after menopause, so clearly estrogen plays a role. Other standard risk factors for fibroids include ethnicity, age, family history, time since last birth, hypertension and diet. Vitamin D deficiency in particular, has been consistently linked with fibroids. [2] 

Genetics clearly plays a role. Having a family member with fibroids increases the risk – and if it’s your mother, you are 3x more likely to develop them too. A hereditary mutation in the FH gene (fumarate hydratase) that causes renal cell carcinoma (HRCC) is now being linked to the development of fibroids, especially at younger ages. [3]

GENETIC EXPRESSION PROVIDES NEW CLUES
Emerging research is revealing the role of underlying molecular pathways and the genes and epigenetics that regulate them in fibroid development and growth. These include estrogen metabolism, inflammation, oxidative stress, insulin and glucose regulation, nutrient processing, telomere length and DNA repair. [4] Interestingly, but perhaps not surprisingly, there is significant overlap with other health conditions including endometriosis, as well as many chronic diseases of aging. 

One of the surprising findings of gene expression research is that almost half of all fibroids have chromosomal abnormalities. [5] Despite this, progression to the cancerous form (leiomyosarcoma) is rare – less than 1%. As researchers look deeper, it appears that it is not the genetic changes within the fibroid that have the most influence on the development of fibroids and the progression to cancer. Rather, it is the microenvironment, or the cellular health around the fibroid, that has this role. [6] 

Therefore, it may be that improving the microenvironment in which these fibroids develop could be effective early intervention strategies. Noninvasive therapies that can reduce inflammation and oxidative stress including diet, medication, PEMF, and photobiomodulation may be new opportunities for early intervention for fibroids as well. [7] 

While genetic expression research on fibroids is shedding light on some of the genomic and genetic alterations that contribute to discrepancies between women of different ethnicities, it is clear that these aren’t the only drivers. [8] As with many other health conditions, where a woman lives and works plays an outsized role.

Environmental toxins including endocrine disruptors and air pollution, stress, and socioeconomic status all have been shown to be connected with higher rates of fibroids. These are likely related to bidirectional effects of epigenetic alterations, access to care and bias within the healthcare system, as well as other factors still to be identified. [9] 

DIAGNOSIS
Ultrasound, and preferably transvaginal ultrasound, is the best initial diagnostic imaging procedure for detection of fibroids. 3D ultrasound can provide even more information than the standard 2D. With the addition of hysterosonography, or introduction of fluid into the uterine cavity under ultrasound guidance, impingement on the uterine cavity can be clearly demonstrated.

 


Image source: Freytag, D., Günther, V., Maass, N., & Alkatout, I. (2021). Uterine Fibroids and Infertility. Diagnostics, 11(8). https://doi.org/10.3390/diagnostics11081455 [OPEN ACCESS}


TREATMENT OPTIONS
Despite many women already having symptoms by age 25, most aren’t diagnosed until their 30’s or 40’s. By that time, the fibroids are typically larger and more problematic. 

Current treatment options include medication to address symptoms – accounting for up to 70% of women at some point. Surgery to remove the fibroids (myomectomy) or the entire uterus along with the fibroids (hysterectomy) is the oldest and most invasive option. Newer techniques such as laparoscopy have improved these surgical approaches. Within the past couple of decades uterine artery embolization (UAE) has offered a less invasive option, and newer noninvasive approaches are now emerging that utilize radiofrequency ablation (RFA), and high intensity focused ultrasound (HIFU). [2] 

Here, too, treatment options are impacted by ethnicity and socioeconomic factors. "Despite minimally invasive options, Black women continue to dominate the percentages of women having hysterectomies for benign disease," Marsh says. "We need to understand why." [1]

One of the main limitations for these newer techniques is that they are more effective on smaller fibroids. Since fibroids tend to grow over time, it would seem a benefit to have earlier diagnosis so that women have better treatment options. In fact, a recent study in Ghana showed that routine ultrasounds at yearly clinic visits increased the rate of diagnosis, and at younger ages. [10] 

THE FUTURE OF FIBROIDS
While more definitive research specific to fibroids is needed, we already have noninvasive tools and strategies to address some of the most common underlying contributors. Let’s advance the science with research as we simultaneously give women more options to proactively improve their health.


REFERENCES

(1) Marsh, E. E., Al-Hendy, A., Kappus, D., et al. (2018). Burden, Prevalence, and Treatment of Uterine Fibroids: A Survey of U.S. Women. Journal of Women's Health, 27(11), 1359-1367. https://doi.org/10.1089/jwh.2018.7076  (2) Freytag, D., Günther, V., Maass, N., & Alkatout, I. (2021). Uterine Fibroids and Infertility. Diagnostics, 11(8). https://doi.org/10.3390/diagnostics11081455  (3) Lu, E., Hatchell, K. E., Nielsen, S. M., et al. (2022). Fumarate hydratase variant prevalence and manifestations among individuals receiving germline testing. Cancer, 128(4), 675-684. https://doi.org/10.1002/cncr.33997  (4) Välimäki N, Kuisma H, Oskari AP et al. (2018) Genetic predisposition to uterine leiomyoma is determined by loci for genitourinary development and genome stability eLife 7:e37110.  (5) Kubínová K, Mára M, Horák P, et al. Genetic factors in etiology of uterine fibroids. Ceska Gynekol. 2012 Feb;77(1):58-60. Czech. PMID: 22536642.  (6) Bharambe, B. M., Deshpande, K. A., Surase, S. G., & Ajmera, A. P. (2014). Malignant Transformation of Leiomyoma of Uterus to Leiomyosarcoma with Metastasis to Ovary. Journal of Obstetrics and Gynaecology of India, 64(1), 68-69. https://doi.org/10.1007/s13224-012-0202-4  (7) Tinelli, A., Vinciguerra, M., Malvasi, A., et al. (2021). Uterine Fibroids and Diet. International Journal of Environmental Research and Public Health, 18(3), 1066. https://doi.org/10.3390/ijerph18031066 (8) Edwards, T. L., Giri, A., Hellwege, J. N., et al. (2019). A Trans-Ethnic Genome-Wide Association Study of Uterine Fibroids. Frontiers in Genetics, 10. https://doi.org/10.3389/fgene.2019.00511  (9) Cheng, L., Li, H., Gong, Q., et al. (2022). Global, regional, and national burden of uterine fibroids in the last 30 years: Estimates from the 1990 to 2019 Global Burden of Disease Study. Frontiers in Medicine, 9, 1003605. https://doi.org/10.3389/fmed.2022.1003605  (10) Mesi Edzie, E. K., Dzefi-Tettey, K., Brakohiapa, E. K., et al. (2023). Age of first diagnosis and incidence rate of uterine fibroids in Ghana. A retrospective cohort study. PLOS ONE, 18(3), e0283201. https://doi.org/10.1371/journal.pone.0283201


ABOUT THE AUTHOR

ROBERTA KLINE, MD (Educational Dir. /Women's Diagnostic Group) is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at https://robertaklinemd.com/




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LINKING DENSE BREAST WITH BREAST CANCER
We have known for a very long time that there is an increased risk of breast cancer for women who have dense breasts. Until recently, the research has been lagging in terms of what's the molecular mechanism, why do dense breasts present an increased risk of breast cancer? Without this knowledge, we can’t address the root causes, and are left with a lot of trial and error based on incomplete understanding. It's very encouraging to know that currently there are 124 clinical trials ongoing looking at dense breasts and the relationship with breast cancer, anywhere from improved diagnostics, to treatment, to prevention, and, what’s close to my heart, to understanding the molecular mechanisms - what's happening at the cell level, at the genetic level that is causing different women to have an elevated risk of breast cancer. (see feature)



Copyright Notice: The materials provided on this newsletter article is copyrighted and is the intellectual property of Dr. Roberta Kline as the writer/producer and or publisher. It is also under the protection of the  (Integrative Cancer Resource Society  and the AngioFoundation(201c3).  This feature report is published strictly for informational purposes within non-commercial use and not for purposes of resale, distribution, public display or performance. Unless otherwise indicated on this web based page, sharing, re-posting, re-publishing of this work is strictly prohibited without due permission from the publishers.  Also, certain content may be licensed from third-parties. The licenses for some of this Content may contain additional terms. When such Content licenses contain additional terms, we will make these terms available to you on those pages (which his incorporated herein by reference).The publishers/producers of this site (BALANCE & LONGEVITY) and its contents such as videos, graphics, text, and other materials published are not intended to be a substitute for professional medical advice, diagnosis, or treatment. For any questions you may have regarding a medical condition, please always seek the advice of your physician or a qualified health provider. Do not postpone or disregard any professional medical advice over something you may have seen or read on this website. If you think you may have a medical emergency, call your doctor or 9-1-1 immediately.  This website does not support, endorse or recommend any specific products, tests, physicians, procedures, treatment opinions or other information that may be mentioned on this site. Referencing any content or information seen or published in this website or shared by other visitors of this website is solely at your own risk. The publishers/producers of this Internet web site reserves the right, at its sole discretion, to modify, disable access to, or discontinue, temporarily or permanently, all or any part of this Internet web site or any information contained thereon without liability or notice to you.

Monday, November 6, 2023

Personalized Health: Nutrition 101 & The Skin

 Reprised Issue for the Women's Health Digest


Nutrition & the Skin:
Choosing the Path of a Certified Nutritionist

By: Mary Nielsen

The skin performs incredibly complex and vital functions for survival. It’s the first line of defense in protecting the body from infection, allergens, and irritants. Secretions of sebum keep the skin soft, supple, moisturized and hydrated. Touch receptors affect our ability to feel pressure, pain and pleasure. The skin’s surface absorbs whatever is applied to it and an exchange of oxygen occurs through the superficial capillaries of the circulatory system. The skin also synthesizes Vitamin D through the absorption of ultraviolet light.

  
Although we’ve intuitively known this, there is now mounting scientific research that the relationship between a person’s overall health and what their skin reveals is strongly connected. For the skin to function optimally, it needs the right nutrients. There are vitamins, minerals, amino acids, proteins and more that specifically nourish the skin and regulate the release of hormones and enzymes that optimize its functions. And, all of this is tied to how our individualized DNA affects skin aging, moisture levels, UV reactions, and collagen production, for example. 

Rosacea is a baffling skin condition, characterized by skin redness, sensitivity, acne-like papules and pustules, that can progress to a condition called rhinophyma, an overgrowth of tissue on the nose or even affect the eyes. It has a genetic component and is often seen in people of Nordic descent. People who have an infectious process due to the h.pylori bacteria, which can cause stomach ulcers, are often prescribed a medication, defined as a proton pump inhibitor. This is the same medication people take for acid-reflux. Uniquely, people who have rosacea and acid-reflux who are prescribed medication for their acid-reflux notice an improvement in their rosacea symptoms. New recommendations for treating rosacea include having the client take a proton pump inhibitor, intended to reduce acid-reflux.  Once I read about this study, I was hooked! The connection between the gut and the skin is undeniable

There is a protein growth hormone called Brain-Derived-Neurotrophic Factor, or BDNF, that functions in the process of learning new information and memory. Some brain disorders, like depression and Alzheimer’s Disease, have been linked to low levels of BDNF. Curcumin is the active ingredient in the spice turmeric. Multiple studies have shown that supplemental curcumin increases levels of BDNF which could lead to potential in treating these disorders.[2]


I’m a late bloomer and an early adapter. That’s why I’ve decided to add to my skillset and become a certified nutritionist. I was in my 40’s when I decided to chuck the nursing career and attend esthetics school. Despite an initial substantial income loss, following my heart and my gut is a decision I have never regretted. I was in my 50’s when I decided to jump into the deep end of the entrepreneur pool. My successful medspa transitioned into owning an esthetics school and empowering others to success in their career passions. And, now in my mid-60’s, I’ve enrolled in an online college program that will guide me to a stronger understanding of nutrition, hormones and DNA. And I plan to build that knowledge into a stronger esthetics program because I believe that an understanding of the connectedness of our skin to every other function in our body is the future of professional skincare. 

So, I am confident that getting certified in nutrition is going to create a stronger esthetics program. Skincare professionals need to have a knowledge of nutrition and I want to create a protocol for a skincare consultation that includes probing deeper into our clients’ genetics and diets and creating individualized treatment plans based on that data.  I don’t believe esthetics education is about beauty. Its about health. Nutrition plays a significant role in homeostasis in our bodies. When our bodies are out of balance, it is evident in the skin. The truth is that we are what we eat!


1 https://pubmed.ncbi.nlm.nih.gov/29996790/#:~:text=therapy%20for%20rosacea.- ,H.,in%20the%20development%20of%20rosacea.
2 https://pubmed.ncbi.nlm.nih.gov/31279955








Going beyond Vitamin B12 for Vegan Diet Support
Written by: Dr. Roberta Kline 

The research is pretty unequivocal: eating a plant-based, whole food diet is overall one of the healthiest strategies. But there are many ways to implement this into one’s diet. For some people, this looks like a Mediterranean Diet. Paleo is another common choice. Others opt for a vegetarian or even vegan diet. And many people will thrive on their chosen version. 

But did you know your genes play a large role in what foods best support your health, and if you don’t choose accordingly the best intentions can actually harm you? Fortunately, there is an easy way to solve this problem: know your genes.

 Genes are the sections of DNA that form the blueprint for every protein in our bodies, including how we digest, transport and utilize the very nutrients in our food. When we have small errors called SNPs (single nucleotide polymorphisms, or SNPs for short) in these genes, that can impact any of the steps along the way. (also see: genomics review article)

 While personalizing nutrition to each person’s genes is a powerful way to optimally support each person’s biochemistry and health, some diets can pose particular challenges. One example is a vegan diet. A vegan diet is comprised completely of plants and plant-based foods; no animal products are consumed. There are many support groups that educate people on the need to supplement with Vitamin B12, as this is a commonly nutritional deficiency for people eating a vegan diet. But there is so much more to know.

 Unfortunately, not all of us are designed genetically to thrive on only plants. While most of the nutrients we need are found in various forms in plants, a number of them require specific enzymes to convert them from the form found in plants to the active form our cells need. But if a person’s DNA has SNPs in one or more of these enzymes, the enzymes don’t do the job that is needed, and nutrient deficiencies occur.

Some nutritional issues are not specific to a vegan diet, such as needing a special form of folate called methylfolate; this can happen with any diet because of a person’s genetic makeup. But other nutritional issues are very specific to vegan diet-gene mismatches.

 Some of the most common mismatches involve vitamin A, vitamin D, omega fatty acids EPA & DHA, and CoQ10. In each case, the nutrient forms found in plants have to be converted by enzymes into their active form needed by cells to function optimally. If a person has SNPs and as a result these enzymes don’t function properly, deficiency results. These nutrients are critical in the functioning of hundreds of biochemical reactions and many biological systems. Over time, deficiencies can lead to mild or serious health issues including fatigue, skin issues, brain fog and difficulty focusing, depression, autoimmune conditions, heart disease, cancer and more.

 Each of these can be prevented by including additional foods that meet these needs, or by choosing specific supplements to fill the gaps. Knowing a person’s unique DNA blueprint enables informed choices  to help each person support their unique biochemistry, and their health, based on their genes.


Contributors-


MARY NIELSEN (Founder/ Faculty Director - Spectrum Advanced Aesthetics)
Mary established and manages a certified aesthetics institution in Portland Oregon supporting the academic leadership and technical ability to grow a med spa profitably. Through collaborative relationships with evolving aesthetics business, her programs (Fearless Beauties and Cascade Aesthetic Alliance) functions to help the esthetician, whether newly licensed or a veteran with education and networking. She is also a published author of best selling textbooks in aesthetic wellness including ADVANCED AESETHETICS and FEARLESS BEAUTIES. Mary is dedicated to bringing change to the esthetics/beauty industry through comprehensive education and empowerment through knowledge.  https://www.fearlessbeauties.org/


ROBERTA KLINE, MD (Educational Dir. /Women's Health Digest)
Dr. Kline is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at https://robertaklinemd.com/






IMAGE GUIDED AESETHETIC TREATMENTS
Edited by: Dr. Robert L. Bard
Authored by a national collaboration of aesthetic specialists

Springer Medical Publishing proudly presents the first installment in clinical aesthetic procedures. 
This book offers a detailed and up-to-date overview of image-guided aesthetic treatments. A wide range of aesthetic image-guided procedures in different body regions are described in more than twenty chapters. For each procedure, the benefits of image guidance are identified and its use is clearly explained. The coverage includes all the major tools commonly employed by today’s aesthetic and plastic surgeons, such as spectral imaging, laser, microfocused ultrasound, and radiofrequency technologies. Image guidance of aesthetic treatments has a variety of benefits: Image-guided treatment by means of non-surgical or minimally invasive modalities greatly reduces patient anxiety and the likelihood of postoperative disfigurement. Image guidance allows the physician to measure the skin thickness and the depth of fat tissue and to evaluate the elasticity of the skin and subcutaneous tissues, improving thermal treatment outcomes. It can also map the arteries, veins, and nerves, thereby providing preoperative landmarks and permitting reduction of postoperative bleeding and avoidance of nerve damage. Furthermore, imaging can non-invasively identify subdermal fillers or implants, assisting in the identification of migration with attendant vascular compromise or nerve entrapment. Image-Guided Aesthetic Treatments will be a valuable guide and reference not only for aesthetic practitioners, plastic surgeons, and other specialists, but also for imaging technicians and interested consumers.





2024 CLINICAL PROFILE OF THE DENSE BREAST PARADIGM - for the Obstetrics & Gynecology Society 
Written by: Roberta Kline, MD
Published by ICRS Medical Press Ltd.

Breast cancer affects the lives of hundreds of thousands of women every year and is a leading cause of death.  While we have made great progress in advancing earlier diagnosis and more individualized treatments, we still need to improve our approach to achieve our ultimate goal - prevention. This requires a deeper understanding of the molecular mechanisms and the multitude of factors that contribute to the development of breast cancer.  

Dr. Roberta Kline, recognized speaker and publishing crusader for women's health brings you a comprehensive review and a deep-dive analysis of the current research  findings about breast density and its major risk factors for breast cancer.  Her reports uncover current imaging practices and clinical protocols updated in great support of breast density detection and the means of addressing this growing condition that affects over 45% of the female population. "Knowing a woman has greater breast density is a critical first step, but it doesn’t end there... we need to go further by understanding the causes of breast density, and how they relate to breast cancer-- we now have another avenue to proactively intervene to reduce risk or even prevent breast cancer in the first place."  This textbook is a champion in targeting the Dense Breast Paradigm as a blueprint and a clear course study for all clinical professionals who are dedicated to women's early detection and prevention programs. (More information)




LAUNCHING IN 2024: NATIONAL COALITION OF WOMEN'S HEALTH SUPPORT& WOMEN'S HEALTH DIGEST  E-MAG
Professional health orgs, foundations and advocates of women's health disorders (primarily cancers) is uniting to form a national alliance of collaborators. This collective group is focused on "doing more together" as far as exploring new resources, sharing current ideas and addressing a wide range of topics about women's issues. Meetings like our latest Women's Powermeet series discussed the latest in diagnostic and therapeutic solutions while introducing who's who in national crusadership in the advocacy realm. Clinicians are also welcome to discuss patient-dedicated road maps and a more thoughtful health analysis and research-based evaluation. It is this level of commitment to women's health that provides a deeper sense of care for the patient that lends itself to a more holistic and integrative strategy to therapeutics. It is also this philosophy that draws more intuitive and insightful awareness on a global scale to offer collaboration platforms too better share insights on a patient's disorders to seek out better solutions. (See Women's Health Digest)

Thursday, November 2, 2023

Personalized Nutrition 101: Nutrition & the Vegan Diet

Reprised Issue for the Women's Health Digest

Nutrition & the Skin:
Choosing the Path of a Certified Nutritionist

By: Mary Nielsen

The skin performs incredibly complex and vital functions for survival. It’s the first line of defense in protecting the body from infection, allergens, and irritants. Secretions of sebum keep the skin soft, supple, moisturized and hydrated. Touch receptors affect our ability to feel pressure, pain and pleasure. The skin’s surface absorbs whatever is applied to it and an exchange of oxygen occurs through the superficial capillaries of the circulatory system. The skin also synthesizes Vitamin D through the absorption of ultraviolet light.

  
Although we’ve intuitively known this, there is now mounting scientific research that the relationship between a person’s overall health and what their skin reveals is strongly connected. For the skin to function optimally, it needs the right nutrients. There are vitamins, minerals, amino acids, proteins and more that specifically nourish the skin and regulate the release of hormones and enzymes that optimize its functions. And, all of this is tied to how our individualized DNA affects skin aging, moisture levels, UV reactions, and collagen production, for example. 

Rosacea is a baffling skin condition, characterized by skin redness, sensitivity, acne-like papules and pustules, that can progress to a condition called rhinophyma, an overgrowth of tissue on the nose or even affect the eyes. It has a genetic component and is often seen in people of Nordic descent. People who have an infectious process due to the h.pylori bacteria, which can cause stomach ulcers, are often prescribed a medication, defined as a proton pump inhibitor. This is the same medication people take for acid-reflux. Uniquely, people who have rosacea and acid-reflux who are prescribed medication for their acid-reflux notice an improvement in their rosacea symptoms. New recommendations for treating rosacea include having the client take a proton pump inhibitor, intended to reduce acid-reflux.  Once I read about this study, I was hooked! The connection between the gut and the skin is undeniable

There is a protein growth hormone called Brain-Derived-Neurotrophic Factor, or BDNF, that functions in the process of learning new information and memory. Some brain disorders, like depression and Alzheimer’s Disease, have been linked to low levels of BDNF. Curcumin is the active ingredient in the spice turmeric. Multiple studies have shown that supplemental curcumin increases levels of BDNF which could lead to potential in treating these disorders.[2]


I’m a late bloomer and an early adapter. That’s why I’ve decided to add to my skillset and become a certified nutritionist. I was in my 40’s when I decided to chuck the nursing career and attend esthetics school. Despite an initial substantial income loss, following my heart and my gut is a decision I have never regretted. I was in my 50’s when I decided to jump into the deep end of the entrepreneur pool. My successful medspa transitioned into owning an esthetics school and empowering others to success in their career passions. And, now in my mid-60’s, I’ve enrolled in an online college program that will guide me to a stronger understanding of nutrition, hormones and DNA. And I plan to build that knowledge into a stronger esthetics program because I believe that an understanding of the connectedness of our skin to every other function in our body is the future of professional skincare. 

So, I am confident that getting certified in nutrition is going to create a stronger esthetics program. Skincare professionals need to have a knowledge of nutrition and I want to create a protocol for a skincare consultation that includes probing deeper into our clients’ genetics and diets and creating individualized treatment plans based on that data.  I don’t believe esthetics education is about beauty. Its about health. Nutrition plays a significant role in homeostasis in our bodies. When our bodies are out of balance, it is evident in the skin. The truth is that we are what we eat!


1 https://pubmed.ncbi.nlm.nih.gov/29996790/#:~:text=therapy%20for%20rosacea.- ,H.,in%20the%20development%20of%20rosacea.
2 https://pubmed.ncbi.nlm.nih.gov/31279955








Going beyond Vitamin B12 for Vegan Diet Support
Written by: Dr. Roberta Kline 

The research is pretty unequivocal: eating a plant-based, whole food diet is overall one of the healthiest strategies. But there are many ways to implement this into one’s diet. For some people, this looks like a Mediterranean Diet. Paleo is another common choice. Others opt for a vegetarian or even vegan diet. And many people will thrive on their chosen version. 

But did you know your genes play a large role in what foods best support your health, and if you don’t choose accordingly the best intentions can actually harm you? Fortunately, there is an easy way to solve this problem: know your genes.

 Genes are the sections of DNA that form the blueprint for every protein in our bodies, including how we digest, transport and utilize the very nutrients in our food. When we have small errors called SNPs (single nucleotide polymorphisms, or SNPs for short) in these genes, that can impact any of the steps along the way. (also see: genomics review article)

 While personalizing nutrition to each person’s genes is a powerful way to optimally support each person’s biochemistry and health, some diets can pose particular challenges. One example is a vegan diet. A vegan diet is comprised completely of plants and plant-based foods; no animal products are consumed. There are many support groups that educate people on the need to supplement with Vitamin B12, as this is a commonly nutritional deficiency for people eating a vegan diet. But there is so much more to know.

 Unfortunately, not all of us are designed genetically to thrive on only plants. While most of the nutrients we need are found in various forms in plants, a number of them require specific enzymes to convert them from the form found in plants to the active form our cells need. But if a person’s DNA has SNPs in one or more of these enzymes, the enzymes don’t do the job that is needed, and nutrient deficiencies occur.

Some nutritional issues are not specific to a vegan diet, such as needing a special form of folate called methylfolate; this can happen with any diet because of a person’s genetic makeup. But other nutritional issues are very specific to vegan diet-gene mismatches.

 Some of the most common mismatches involve vitamin A, vitamin D, omega fatty acids EPA & DHA, and CoQ10. In each case, the nutrient forms found in plants have to be converted by enzymes into their active form needed by cells to function optimally. If a person has SNPs and as a result these enzymes don’t function properly, deficiency results. These nutrients are critical in the functioning of hundreds of biochemical reactions and many biological systems. Over time, deficiencies can lead to mild or serious health issues including fatigue, skin issues, brain fog and difficulty focusing, depression, autoimmune conditions, heart disease, cancer and more.

 Each of these can be prevented by including additional foods that meet these needs, or by choosing specific supplements to fill the gaps. Knowing a person’s unique DNA blueprint enables informed choices  to help each person support their unique biochemistry, and their health, based on their genes.


Contributors-


MARY NIELSEN (Founder/ Faculty Director - Spectrum Advanced Aesthetics)
Mary established and manages a certified aesthetics institution in Portland Oregon supporting the academic leadership and technical ability to grow a med spa profitably. Through collaborative relationships with evolving aesthetics business, her programs (Fearless Beauties and Cascade Aesthetic Alliance) functions to help the esthetician, whether newly licensed or a veteran with education and networking. She is also a published author of best selling textbooks in aesthetic wellness including ADVANCED AESETHETICS and FEARLESS BEAUTIES. Mary is dedicated to bringing change to the esthetics/beauty industry through comprehensive education and empowerment through knowledge.  https://www.fearlessbeauties.org/


ROBERTA KLINE, MD (Educational Dir. /Women's Health Digest)
Dr. Kline is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at https://robertaklinemd.com/






IMAGE GUIDED AESETHETIC TREATMENTS
Authored by a national collaboration of aesthetic specialists

Springer Medical Publishing proudly presents the first installment in clinical aesthetic procedures. 
This book offers a detailed and up-to-date overview of image-guided aesthetic treatments. A wide range of aesthetic image-guided procedures in different body regions are described in more than twenty chapters. For each procedure, the benefits of image guidance are identified and its use is clearly explained. The coverage includes all the major tools commonly employed by today’s aesthetic and plastic surgeons, such as spectral imaging, laser, microfocused ultrasound, and radiofrequency technologies. Image guidance of aesthetic treatments has a variety of benefits: Image-guided treatment by means of non-surgical or minimally invasive modalities greatly reduces patient anxiety and the likelihood of postoperative disfigurement. Image guidance allows the physician to measure the skin thickness and the depth of fat tissue and to evaluate the elasticity of the skin and subcutaneous tissues, improving thermal treatment outcomes. It can also map the arteries, veins, and nerves, thereby providing preoperative landmarks and permitting reduction of postoperative bleeding and avoidance of nerve damage. Furthermore, imaging can non-invasively identify subdermal fillers or implants, assisting in the identification of migration with attendant vascular compromise or nerve entrapment. Image-Guided Aesthetic Treatments will be a valuable guide and reference not only for aesthetic practitioners, plastic surgeons, and other specialists, but also for imaging technicians and interested consumers.





2024 CLINICAL PROFILE OF THE DENSE BREAST PARADIGM - for the Obstetrics & Gynecology Society 
Written by: Roberta Kline, MD
Published by ICRS Medical Press Ltd.

Breast cancer affects the lives of hundreds of thousands of women every year and is a leading cause of death.  While we have made great progress in advancing earlier diagnosis and more individualized treatments, we still need to improve our approach to achieve our ultimate goal - prevention. This requires a deeper understanding of the molecular mechanisms and the multitude of factors that contribute to the development of breast cancer.  

Dr. Roberta Kline, recognized speaker and publishing crusader for women's health brings you a comprehensive review and a deep-dive analysis of the current research  findings about breast density and its major risk factors for breast cancer.  Her reports uncover current imaging practices and clinical protocols updated in great support of breast density detection and the means of addressing this growing condition that affects over 45% of the female population. "Knowing a woman has greater breast density is a critical first step, but it doesn’t end there... we need to go further by understanding the causes of breast density, and how they relate to breast cancer-- we now have another avenue to proactively intervene to reduce risk or even prevent breast cancer in the first place."  This textbook is a champion in targeting the Dense Breast Paradigm as a blueprint and a clear course study for all clinical professionals who are dedicated to women's early detection and prevention programs. (More information)




LAUNCHING IN 2024: NATIONAL COALITION OF WOMEN'S HEALTH SUPPORT& WOMEN'S HEALTH DIGEST  E-MAG
Professional health orgs, foundations and advocates of women's health disorders (primarily cancers) is uniting to form a national alliance of collaborators. This collective group is focused on "doing more together" as far as exploring new resources, sharing current ideas and addressing a wide range of topics about women's issues. Meetings like our latest Women's Powermeet series discussed the latest in diagnostic and therapeutic solutions while introducing who's who in national crusadership in the advocacy realm. Clinicians are also welcome to discuss patient-dedicated road maps and a more thoughtful health analysis and research-based evaluation. It is this level of commitment to women's health that provides a deeper sense of care for the patient that lends itself to a more holistic and integrative strategy to therapeutics. It is also this philosophy that draws more intuitive and insightful awareness on a global scale to offer collaboration platforms too better share insights on a patient's disorders to seek out better solutions. (See Women's Health Digest)


Elevating Women's Wellbeing at Work

Insights from the US Surgeon General's Report Written by:   Joyce Gregory, MD Click to download full report Promoting the mental healt...