Newsletter AUGUST 2005

Article:
Fertility Awareness for Reproductive Health

Research Review
Dark Chocolate and Heart Health

Move Your Body
Mix Things Up with Cross Training

Food For Thought
Mayonnaise

Recipe of the Month
Cranberry Sunflower Broccoli Salad

Quote:
“We must not cease from exploration, and the end of all our exploring will be to arrive where we started and to know the place for the first time.”
TS Eliot

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Fertility Awareness for Reproductive Health
By Sarah Cimperman, ND

Despite decades of medical progress and technological advancement, researchers have yet to design a perfect form of birth control and many women still struggle with infertility. Ancient wisdom may help answer these modern dilemmas. One of the oldest and most widely practiced strategies of conception and contraception, Fertility Awareness empowers women to become knowledgeable and active in their reproductive health. Whether they want to avoid a pregnancy, achieve one or simply learn more about their bodies, understanding monthly hormone cycles is essential for better health and better health care.

The Fertility Awareness Method
Fertility Awareness (FA), also known as the Sympto-Thermal Method, helps women and couples understand basic information about fertility and reproduction. Three fertility signs – waking body temperature, cervical fluid and position of the cervix – are charted on a daily basis to identify the fertile days of each menstrual cycle, and to determine if and when ovulation and pregnancy occur.

Like any new skill, FA must be learned and used correctly to be effective. Many women can learn the charting techniques and rules of interpretation by reading a book. Others may prefer to take a class with a certified instructor. Once the basic principles are learned, charting only takes minutes each day, but requires a commitment to consistent practice.

Contraception
Unlike other methods of contraception, Fertility Awareness is free of chemicals, exogenous hormones and side effects. Through identification of fertile days, FA shortens the time that couples need to use barrier contraceptive devices, such as condoms, diaphragms or cervical caps. Fertility Awareness is often confused with the Rhythm Method and Natural Family Planning. Although none prevent sexually transmitted diseases, all three can be used as birth control, with varying degrees of success.

The Rhythm Method relies on past cycles to predict future fertility. In contrast, FA is based on daily observation of current fertility signs to determine if a woman can become pregnant on any given day. Women are only fertile a few days each month, around the time of ovulation. Because the length of each cycle and the exact day of ovulation may vary from month to month for each woman, FA is much more accurate than the Rhythm Method.

Natural Family Planning is similar to FA, but couples abstain from intercourse during fertile days, rather than using barrier methods of contraception. Couples who use Natural Family Planning may have religious reasons to choose abstinence over contraception, but like couples who practice FA, they desire a natural method of effective birth control. According to Planned Parenthood, Fertility Awareness is 97 to 99 percent effective when used correctly.

Infertility
Just as the identification of fertile days can be used to avoid pregnancy, it can also be used to achieve pregnancy. Menstrual cycles vary among women, usually from 24 to 36 days, but many health care practitioners assume that women have 28 day cycles and ovulate on the fourteenth day. Women who are treated for infertility often undergo expensive and uncomfortable tests and procedures, but these are only effective when timed correctly.

When couples are trying to get pregnant, FA will not only determine when sexual intercourse is likely to result in conception, but it can provide vital information for the diagnosis and treatment of infertility. Women who practice FA can help their doctors determine whether their fertility problems result from hormone imbalance, infertile cervical fluid, anovulation, late ovulation, a short luteal phase or miscarriage. With this information, doctors can time tests and procedures to ensure optimal results.

Reproductive Health
Fertility Awareness can also be a useful tool in other areas of reproductive health. When women chart their fertility signs, they will recognize changes that may indicate potential health problems. Those who experience irregular bleeding, cervical abnormalities, premenstrual syndrome and vaginal or urinary tract infections can provide their doctors with information to facilitate diagnosis and prevent unnecessary and invasive tests. Many health care practitioners diagnose common conditions based on the average women’s symptoms, but women who practice FA can help their doctors identify individual irregularities based on the unique nature of their menstrual cycle.

Resources
To find a certified instructor near you, contact your local health department or Planned Parenthood for information and referrals. For classes and workshops in New York City, contact the Fertility Awareness Center at 212-475-4490. Toni Weschler’s book, “Taking Charge of Your Fertility” is also an excellent resource and a good place to start for women and couples who want more information about Fertility Awareness.

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Dark Chocolate and Heart Health

Cocoa comes from the plant Theobroma cacao. Several recent studies confirm dark chocolate’s heart-healthy effects, primarily due to compounds such as flavonoids, polyphenols, fatty acids, procyanidins and trace minerals. These contribute to cocoa’s ability to increase HDL (good) cholesterol, make LDL (bad) cholesterol more resistant to oxidative damage, decrease blood pressure, improve endothelial (blood vessel) function and increase sensitivity to insulin. Cocoa also has antioxidant properties and inhibits the formation of blood clots.

The benefits of dark chocolate aren’t found in milk chocolate or white chocolate (which isn’t even chocolate because it contains no cocoa). If you have a sweet tooth, choose an occasional ounce or two of dark chocolate over sugary snacks such as cookies, candy, cake, ice cream and pastries. Be aware that the extra calories can add up to weight gain, so consume in moderation and plan your diet and exercise accordingly.

Here are summaries of some dark chocolate studies:

Blood Pressure, Glucose and Insulin Response

Researchers in Italy compared the effects of dark chocolate to white chocolate in relation to blood pressure, blood glucose and insulin response. Fifteen healthy adults consumed dark chocolate, containing 50 mg of polyphenols for fifteen days. After a break of seven days, the same group consumed white chocolate, which contained no polyphenols, for fifteen days. Dark, but not white, chocolate was associated with lower systolic blood pressure, higher sensitivity to insulin and lower insulin resistance, which translates into reduced risk for diabetes.

Grassi D et al. Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons. Am J Clin Nutr. 81(3):611-4, Mar 2005.

Cholesterol and Oxidative Damage

Researchers in Finland studied 45 healthy adults during a three-week clinical trial. One group consumed 75 grams of white chocolate, another group consumed 75 grams of dark chocolate and the last group consumed 75 grams of high-polyphenol chocolate. An increase in HDL (good) cholesterol was observed in the groups who ate the dark chocolate and high-polyphenol chocolate, while the group who ate white chocolate experienced a small decrease. Lipid peroxidation (the oxidation of fats which forms dangerous free radicals that damage cells) decreased in all three groups. Researchers concluded that polyphenols in cocoa increase the HDL (good) cholesterol and the fatty acids in chocolate may modify the composition of LDL (bad) cholesterol, making it more resistant to oxidative damage.

Mursu J et al. Dark chocolate consumption increases HDL cholesterol concentration and chocolate fatty acids may inhibit lipid peroxidation in healthy humans. Free Radic Biol Med. 37(9):1351-9, Nov 2004.

Blood Vessel Function

Researchers in Greece studied 17 healthy volunteers who ate 100 grams of dark chocolate. They found an acute (short term) beneficial effect on blood vessels and concluded that consumption of dark chocolate may have a protective effect on the cardiovascular system.

Vlachopoulos C et al. Effect of dark chocolate on arterial function in healthy individuals. Am J Hypertens 18(6):785-91, Jun 2005.

Platelet Aggregation

Researchers in Scotland studied the effect of 100 grams of white chocolate, 100 grams of milk chocolate and 100 grams of dark chocolate on thirty healthy volunteers. Dark chocolate inhibited platelet aggregation, which leads to blood clot formation. This was not observed in those who ate white chocolate or milk chocolate. Researchers concluded that dark chocolate may play a role in the prevention of cardiovascular and thromboembolic diseases (such as stroke).

Innes AJ et al. Dark chocolate inhibits platelet aggregation in healthy volunteers. Platelets, 14(5):325-7, Aug 2003.

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Mix Things Up with Cross Training

Summer is the perfect time to concentrate on adding variety to your fitness routine. New activities strengthen the cardiovascular system and prevent exercise boredom and accommodation. Introducing different movements will challenge new muscles and bones, so the same joints are not continuously stressed. Chose activities that interest you to make exercise fun, rather than a chore, and you will be more likely to make fitness a regular part of your life.

You can cross train at the gym by choosing different machines on different days (stationary bike, treadmill, elliptical machine, resistance equipment or free weights) but when the weather is nice, mix up your fitness program with outdoor sports. Walk on the beach, swim in the ocean, rollerblade, jog in the park, play volleyball and tennis, ride your bike or go for a hike. Don’t forget to stay hydrated and use sun block to prevent burns.

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Real Mayonnaise

Soon after my French friend Camille moved to the United States, she commented how strange it was for her to see Americans buy mayonnaise at the store and keep it in the fridge for months. I thought it was equally strange for her to think that mayo is the easiest thing to make from scratch and should always be prepared fresh. It turns out that she was right.

Although it has gotten a bad reputation, real mayonnaise is really just egg yolk and olive oil, with a little seasoning. If you use high quality ingredients such as fresh eggs from organic, free-range chickens and cold-pressed extra virgin olive oil, you will make a good mayonnaise that is not unhealthy when enjoyed in moderation. And it only takes minutes to whip up.

Because fresh mayonnaise contains raw egg yolk, there is a very small chance of Salmonella contamination. Rinsing eggs before you use them reduces this risk because the bacteria is usually is transmitted on the shell of the egg.

To make your own mayonnaise:

2 egg yolks from organically fed, range-free chickens
1 tbsp Dijon mustard
1 cup extra virgin olive oil
Lemon juice or vinegar
Salt and pepper

Combine the egg yolk and mustard in a small bowl and whisk until creamy.* Continue to whisk while adding the olive oil drop by drop until the mixture begins to thicken. Then add the remaining oil in a thin stream until the mixture is thick. Use the lemon juice or vinegar to thin the mayonnaise to desired consistency and taste. Add salt and pepper to taste. Store what you don’t use fresh in the refrigerator for up to two days.

Optional: To give your mayonnaise extra flavor, mix in a pinch of curry powder, minced garlic, chives or tarragon once it is prepared.

* A food processor or egg beater will make this easier, but it is not required.

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Cranberry Sunflower Broccoli Salad

This recipe contains egg. If you are avoiding eggs, substitute 1/3 cup olive oil for 1/3 cup mayo and use ¼ cup vinegar rather than 2 teaspoons. The numerous health benefits of broccoli, red onion, cranberries, vinegar, honey and raw seeds balance out the small amount of cholesterol derived from egg yolk in the mayonnaise.

For people who are not sensitive to eggs, eating them in moderation is not unhealthy, and their effect on blood cholesterol is less harmful than previously thought. Eggs provide an excellent source of protein (about 6 grams per whole egg) as well as nutrients such as tryptophan, calcium, selenium, iron, zinc, magnesium, iodine, phosphorus, molybdenum, biotin, choline, folate and vitamins A, E, D, K, B1, B2, B5, B6 and B12.

2 heads broccoli
½ medium red onion, thinly sliced
½ cup dried cranberries*
1/3 cup real mayonnaise**
2 tsp vinegar of choice
2 tsp honey
¼ cup raw sunflower seeds
¼ cup raw pumpkin seeds

Clean broccoli, remove florets and chop them into bite-sized pieces. Trim the bottom inch or two from the broccoli stem and use a knife to peel off the tough outer layer. Chop the tender middle into bite-sized pieces and add them to a big bowl with the florets, sliced onion and cranberries. Toss to combine and set aside.

Mix the mayo, vinegar and honey in a small bowl until well combined. Taste and add more vinegar if desired.

Toss dressing with the broccoli mixture until evenly coated (you don’t have to use all of the dressing). Sprinkle with sunflower seeds and serve immediately.

You can prepare this salad ahead of time, but don’t add dressing and sunflower seeds until you are ready to eat it. The broccoli should have a crisp texture and the sunflower seeds should be firm; both can become soggy if they are wet for too long.

* Dried cherries or golden raisins can be substituted for cranberries.

** To make your own mayonnaise:

2 egg yolks from organically fed, range-free chickens
1 tbsp Dijon mustard
1 cup extra virgin olive oil
Lemon juice or vinegar
Salt and pepper

Combine the egg yolk and mustard in a small bowl and whisk until creamy (a food processor or egg beater will make this easier, but it is not required). Continue to whisk while adding the olive oil drop by drop until the mixture begins to thicken. Then add the remaining oil in a thin stream until the mixture is thick. Use the lemon juice or vinegar to thin the mayonnaise to desired consistency and taste. Add salt and pepper to taste. Store what you don’t use fresh in the refrigerator for up to two days.
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