Friday, December 28, 2007

A love note from my son

"You are sometimes a stupid iteit but I love you."

I guess that says it all....

Thursday, December 27, 2007

2 more on diet and cancer

I'm putting up links to 2 more articles on the topic of cancer and diet as I try to figure this whole thing out myself.

What Causes Cancer? Probably Not You by Barbara Ehrenreich

and

Diet and Breast Cancer: Conclusions Are Hard to Swallow by Jan Kirsch, M.D., M.P.H.

Still thinking this through, but I really think the environment is the cause, and no one wants to deal with it. By the way, I currently know 3 women dealing with breast cancer and one with lung cancer, all around my age. So this is becoming very personal.

Sex ed redux

There's an excellent op-ed in today's Boston Globe about the Spears-teen pregnancy issue. Take a look. It kind of amazes me that I started working in family planning here in Boston in 1986 (!) and the same issues still remain...we're still fighting about comprehensive sexuality education and its absolute necessity. Will we ever learn?

Monday, December 24, 2007

Diet and infertility: is there a link?

Oh, Walter. Say it isn't so!

I first became aware of Walter Willett when I worked at Harvard School of Public Health a few years ago. He is the chair of the Nutrition Dept. there, and in addition to doing research, wrote a number of books on diet that I found really useful. The first is Eat, Drink and Be Healthy: The Harvard Medical School Guide to Healthy Eating, and the second is Eat, Drink, and Weigh Less: A Flexible and Delicious Way to Shrink Your Waist Without Going Hungry which he co-wrote with Mollie Katzen of Moosewood fame. Willett promotes a very healthy diet, with lots of fruits and vegetables, whole grains, low fat proteins, low fat dairy, and even a little chocolate and wine for good measure.

On the other hand, there are a few things that Willett is doing that I don't agree with. One, that I mentioned in a previous post, is research that has to do with the connection between diet and cancer. While I believe that there is some connection, I don't think the risk is as high as Willett professes.

And now Willett has come out with a book professing that improved diet will improve your fertility. Judy Foreman takes a look at this book in today's Globe. Her critique, which I agree with, is as follows:

Observational studies like the Nurses' Health Study do not prove that a behavior causes or prevents a health problem, only that it might do so. To prove that diet affects fertility, researchers would have to take a group of women with diagnosed infertility and randomly put half on a special diet and half on a regular diet and compare conception rates.

This would be an interventional study, which would have come closer to the "gold standard" of medical research and would have provided the solid ground to offer advice. Such a study could also show how long a woman would need to eat this way to affect her fertility.

So what she's saying is that you can't take data like the Nurses' Health Study, which asks a huge group of nurses to fill out questionnaires about health issues over their lifetime, and then analyze that data and go back and say that because this group of nurses has a healthier diet, they had better fertility. This type of study only shows correlation, not causation. In other words, there seems to be a link between this type of diet and fertility, but we can't say definitively that the diet improves fertility. For example, it could be that women who are more fertile and who have more kids, eat a healthier diet because they are feeding their kids a healthier diet. So it could be that their diet had nothing to do with their fertility.

In the end, there is nothing wrong with eating the diet that Willett promotes. It's a great, healthy diet. The problem is that he's saying that it will increase your fertility. I wish he would just stick to promoting a healthy diet, and stop claiming that it will reduce your chances of cancer and increase your fertility. These things are sexy and sell books, but it isn't good practice or good science to promote statements like these that haven't been proven.

Sunday, December 23, 2007

Saturday, December 22, 2007

Teen pregnancy... again...

I'm typically not interested in pop culture, per se, but the interest in Britney Spears' sister's pregnancy has caught my eye this week. Yes, Jamie Lynn Spears, at the tender age of 16, star of the hit TV show "Zoey 101" on Nick, is pregnant. And unmarried. And continuing the pregnancy and keeping the child, I assume. What will everyone involved do?

This interests me for a number of reasons. First, I worked in family planning for many years. Back in the '80s, teen pregnancy was a hot topic. It seems to have died down over the years, but every now and then, it rears its ugly head (excuse the mixed metaphors).

Secondly, my son, who is 8, watches this show. I think I've glanced at it, and it's really quite a silly show, with a bunch of young teens living at a "boarding school" which seems more like college (nary an adult in sight), having fun, and rarely doing any school work.

Third, the political climate right now is very conservative, so it should be interesting to see if presidential candidates, for example, start weighing in on what Ms. Spears should do about her unintended pregnancy. She shouldn't have been having sex in the first place, right? But since she did, and since she got pregnant, she definitely has to have the baby. But maybe the right thing to do is to place the baby for adoption. What kind of mother would she be, being a star with a busy career, and a with a sister who can't parent her own kids? (I'm just imagining what, say, Romney or Huckabee might be thinking...)

And fourth, and perhaps most interesting, is that Nick has to save it's behind, so what is Nick going to publicly say? After all, kids in the pre-teen age bracket watch this show, and idolize Spears, and what kind of role model is she providing? So that should be very interesting, to see how they spin this pregnancy.

My thoughts on the matter? Well, my question is, why wasn't she (and her supposed 'long-time boyfriend') using any birth control? So that would be the first thing. They should have known that having sex unprotected would lead to pregnancy. (I'm assuming they weren't using birth control: maybe they were and it failed?) And by announcing her pregnancy to the world, she is effectively eliminating any chance of making a private decision, i.e. if she even thought about abortion, now that's out of the question. Because if she has an abortion and states it publicly, she is effectively ruining her career (see conservative political climate, above). So now, she really only has two choices: continue the pregnancy and parent the child, or continue the pregnancy and place it for adoption. Somehow I doubt she will be placing it for adoption. So now she really has only one choice.

So my thoughts would be, what do we learn from this? 1) use birth control if you decide to have sex. 2) if the birth control fails and you get pregnant, don't tell everyone until you have decided what you want to do 3) if you are a rich and famous TV star, you can probably have a baby and continue your career anyway, so maybe it doesn't really matter after all....

I'm so cynical.

In the best of all possible worlds, Nick would use this as a teachable moment, and would educate its young viewers about teen sex, teen pregnancy, and everything that goes along with it. But that's not going to happen, is it?

P.S. a few interesting links on this topic
Explain that to your kids
Nick mulling post-Spears pregnancy show

Friday, December 21, 2007

3 snowstorms so far....


Trees are outlined with snow...or snow is outlining the trees...not sure which!



I guess grilling is out for tonight?

Wednesday, December 19, 2007

More Bah Humbug

I cannot WAIT for Christmas to be over. I'm so sick of the ads, and the songs, and the constant discussion on the radio and the TV and the internet and the newspaper of what to buy and what to eat and what to do.... argh!!!!!!!!!!!!!

What is the big deal about Christmas, anyway? It's just a holiday!

And what is the big deal about Santa Claus? Why is it that folks feel that lying to their children about a fictional character who brings them toys is a good thing? Can someone please explain this to me? Why is making a list of toys that you want and then thinking that Santa brings them to you a good thing? Why is buying your family an over-abundance of presents a good thing?

And what is the deal about all the presents???? Why is it necessary to give your kids 5 or 7 or 10 presents all at once? What does this have to do with Christ's birth?

I'm very confused, and cranky (as if you haven't noticed). Can someone please explain to a Jewish girl what is going on? Thanks.

Sunday, December 16, 2007

Recent Photos








Winter wonderland #1








Winter wonderland #2













Kippot I've been sewing

Tradition, tradition

Tradition, tradition
Tradition
Tradition, tradition
Tradition....
I've been thinking a lot about tradition lately. On every radio show, every podcast, every blog, everyone is talking about their Christmas traditions, and how it wouldn't feel like Christmas without x, y, or z.

So I've been wondering: how does a tradition become a tradition? How often, or for how long, do you need to do something before it takes on the label "tradition"?

A long time ago, I was visiting a friend who has a daughter around the same age as my son. She was marveling at how quickly something became a "tradition" with her 3-year-old. Sometimes, she marveled, all you had to do was do something once, and it was a tradition!

I see this happening now with my 8-year-old son, as well. Sometimes we will do something once or twice, and suddenly -- he wants to do that thing exactly that same way over and over again. For example, he started asking me to tickle him while he was lying on the couch in the TV room, and he would say a certain phrase. Pretty soon, he only wanted me to tickle him while he lay on the couch saying that exact phrase. Now it's practically become a tradition.

Or when he comes home from school -- starving -- he always asks for the same foods, in the same order. Ice cream. Then hot dogs. Then something to drink. I guess you could say it's become a habit. Or a tradition.

What I'm trying to say is: traditions are just things we are used to doing in a certain way. They are really habits that have taken on a life of their own, so to speak.

So when people talk about their traditions - I know, this sounds really cynical! - I think they are simply talking about the way they are used to doing something. It may not be something that has to be a certain way: they just are used to it that way, and it feels good and familiar to do it that way over and over again.

On the other hand, there are religious traditions that are supposed to come from someplace (i.e. G-d?) or at least from people of your faith from a long time ago. Now, again, my thought is that the same rule applies: someone starting doing something a certain way, others picked up on it, and pretty soon it was a full-fledged "tradition"! But does that mean it's the best way? The right way? The way we should do it today?

One thing I like about Conservative Judaism (in this case Conservative means "conserve" as in conserving the past, not conservative politically...) is that it is willing to change as the world changes. For example, just this past year, Conservative Judaism's ruling body decided to allow gays and lesbians to be married and included in their religious communities. This is actually a really big deal for Conservative Judaism, and a pretty brave stance for them to take.

As I sat in shul (synagogue) yesterday, singing the prayers that sometimes mean something, sometimes don't, but which are mostly familiar to me, I was thinking about this tradition thing. Someone a long time ago, some rabbis, decided to put this prayer and that prayer together, and make them part of the Shabbat service, and now we do it that way because... that's how it's been done for a long time!

I guess my point is: many traditions are nice, and they make you feel good, and secure, and they can be comforting. But they don't have to continue if they no longer make sense to you. Unfortunately, in Judaism, we are asked to keep some traditions that I don't feel comfortable with, and this causes a lot of angst for me. I have decided not to keep Kosher, for example, and I still feel pangs of guilt about this pretty frequently.

I think a big issue in our post-modern age (!) is how to create traditions that are meaningful to us, that make us feel connected with the past, but also make sense in the present. This is the challenge.

Chanukah Rap

This is the funniest thing I've seen in a long time -- enjoy!!!

Thursday, December 13, 2007

First snowstorm of the season

Okay, they predicted it, we knew it was coming. Schools let out early. Everyone stocked up on groceries. But now traffic is at a STANDSTILL. It usually takes me about 7 minutes to get home from picking up my son, and today it took.... are you ready.... almost 2 hours. What is going on? My husband is at work, and he can't even get out of the parking lot, things are backed up so badly. He may have to spend the night at work, which would be a first.

I forgot to mention that we live on a hill, and when my son and I arrived home from school, the hill wasn't plowed yet. I couldn't get UP the hill. The car kept sliding. In the end, after trying several alternate ways, I managed to get up a different side of the hill, and then down the hill to our house. Sheesh!

And it's not even a PRETTY snow. It's kind of granular, not flaky.

Bah humbug!

Tuesday, December 11, 2007

Thank you, Jane Swift

I'm not the only one annoyed by Mitt Romney's flip-flopping ways. Thanks, Jane.

More misinformation on the internet

GA few months ago, a listener of Pediacast (a wonderful podcast on pediatrics) asked a question about Gardasil, the new HPV vaccine. Gardisil prevents cervical cancer, and in my mind, from a public health perspective, should be a no-brainer. Who doesn't want to prevent cancer? This is one of the truly easiest cancers to prevent! A young woman gets 3 shots, and she is prevented from cervical cancer. Why do you think women get pap smears? To detect cervical cancer!

So back to my story... So the listener said that she'd heard about some negative side-effects to the vaccine, and did Dr. Mike know anything about this? Dr. Mike said he hadn't heard anything like this, and that he was providing Gardasil to his patients. But my interested was piqued.

So I looked on the internet (back to Google) under Gardasil and side-effects, and low and behold -- I shouldn't be surprised by now -- tons of misleading information about Gardasil and a whole variety of side effects! Sound familiar?

If you look closely at the sites, you will find pro-life (anit-abortion) sites with misleading information about Gardasil; sites by lawyers who claim to have documentation from individual women about side effects; and so on. Ad nauseum.

I took a look at the medical literature, and this is what I found. Gardasil was tested on 12,000 women, half who received it, and half who received an injection with a placebo. Of those women, .7% (less than 1%) of the women who received the Gardasil injection had a serious side effect, and .9 (less than 1%) of the women who received the placebo injection had a serious side effect.

That means, first of all, that less than 1% of 6000 women (that's less than 60 women) who received Gardasil had a serious side effect. It also means that less than 60 women who received the placebo injection had a serious side effect. That means that statistically, women who received the Gardasil injection were no more likely to have a serious side effect than women who received the placebo injection. (As a matter of fact, more women receiving the placebo injection had serious side effects!) This data reassures me that Gardasil is in fact safe.

I'm starting to feel angry at Google. I'm sure they don't have a way (or a desire) to check every site that they post, but the amount of inaccurate health information they are showing is starting to alarm me. I wonder if there is anything I can do about this.

Sunday, December 09, 2007

Religion, Romney, and Privacy

I'm not in love with Mitt Romney, as should be clear after this post and this one. As far as I'm concerned, he's a smooth talking, handsome, rich politician who pretends to believe in causes, and then later "changes his mind" when the political winds shift in a different direction. He did this with the issues of gay marriage and abortion (choice), among other issues. First -- when he wanted to be Governor of Massachusetts -- he was for them, now that he wants to be President -- he is against them.

I can't stand him so much, I'd almost forgotten that he is a Mormon, not that that makes me like him any more or less (because I highly doubt his family is anything like Big Love). But apparently, his Mormonism is a rather large issue in the presidential campaign -- at least to Conservative Christian Republicans -- so yesterday Romney gave a speech about it. Or rather, gave a speech called "Faith in America.

There has been quite a bit of commentary about his speech in the media: here's an article from the Globe and here's the Globe's editorial.

Here is a sample, as quoted from the Globe editorial:
"Freedom requires religion just as religion requires freedom," he (Romney) said. And just to make sure they grasped which religion he was espousing, he added: "I believe that Jesus Christ is the Son of God and the Savior of mankind."

Romney got applause when he criticized those who would supplant a faith-centered nation with "the religion of secularism." But given the amount of violence and intolerance that various religions have generated throughout history, it is unwise to insist that religious belief is a prerequisite for freedom.

Someone with ambitions to lead all the people in a pluralistic society should not identity so closely with any religion or religious figure, even one as revered as Jesus.
So where do I begin? "Freedom requires religion, just as religion requires freedom." Well...no...if you live in a free society, you are free to practice your religion, but it is not required. You are also free NOT to practice religion. What is he trying to say? That those who don't practice religion aren't free? Or shouldn't be allowed to live in a free society?

Romney was critical of those who would replace a faith-centered nation with "the religion of secularism." But, as the Globe commented in its editorial, religion doesn't guarantee a just society - quite the opposite is possible. Look what is going on in the world today in the name of religion! And what is this "religion of secularism" to which he is referring?

I agree with the Globe's comment that "someone with ambitions to lead all the people in a pluralistic society should not identity so closely with any religion or religious figure, even one as revered as Jesus." Why is it that politicians now-a-days have to profess their belief in Jesus every 5 minutes? This drives me crazy. First of all, I'm not really interested in their religious beliefs. Second of all, I don't really want to know who or what they believe in. It all seems too personal to me. But maybe that's the problem. Politics is becoming too personal. Hell, it seems like all we're interested in these days is politician's religious views and their sex lives!

So... I'm not sure where this leaves me. I still dislike Romney, and I don't like the way religion is becoming such a topic of public discourse in the U.S. I realize that most of the population of the U.S. identifies as being Christian (see yesterday's post), but I'm not sure that that justifies such a public display of religious zeal. I'm sure that many Christians in American would rather have their religious views and feelings kept private. And they probably would like the same from their politicians.

Saturday, December 08, 2007

Happy Chanukah!

Religion in America

I've been working on something about Mitt Romney's speech about religion, and I just can't seem to get it right. So that piece will have to wait. But I was doing some research today, and this is what I came up with about religion in America.

In 2001, a survey was done that represents the religious identification 207 million Americans. You can find it here. They found that of 207 million Americans, there are:

159 million Christians 77%
of these
Evangelical 28%
Catholic 25%
Mainline Protestant 16%

7.7 million all other religions combined 4%

29 million no religion 14 %

11 million refused the survey 5%

(Just to give you an interesting comparison, there were 2.8 million Jews. Wow. No wonder it feels like everyone else is celebrating Christmas... they are!)

So if you look at this, 3/4 of America is Christian, and the last 25% is made up of a small (4%) minority of other religions, plus 14% with no religion and 5% refused. WOW!

Now I really feel like a minority. These numbers are amazing! I guess I'm starting to understand why the Christian Conservatives have such a big say in this upcoming election...

Monday, December 03, 2007

Red meat = bad

I try to feed my family (and myself) a healthy diet, and I think I do a pretty good job. We (well, my husband and I) eat lots of vegetables, beans, grains (not always whole grain, but sometimes) and I try to have meat/chicken/fish be just a part of the meal. I try.

But today, this article in the Globe gave me pause. Is eating processed or red meat linked to a higher risk of cancer? posits the article. The answer?
Yes, according to a new report from the American Institute for Cancer Research, a nonprofit based in Washington that studies links between diet and cancer.
Furthermore...

The group recommended limiting consumption of red meat to 18 ounces (cooked) per week. "It's eating more than 18 ounces a week that increases risk substantially, said Karen Collins, nutrition adviser to the American Institute for Cancer Research.

The evidence against processed meat such as bacon, ham, sausage, and lunchmeat is "even more rigorous," the group said, adding that it could find no level at which consumption of these products was safe. While that is a clear warning, it doesn't mean you should never eat processed meat, just that you should eat it sparingly, Collins said.

I've been aware of this agency for some time now, and I think their message is a good one. I just don't know how I'm going to implement it, realistically, in my home.

Here is more info about red and processed meat
and here's what they have to say about drinking alcohol

!!!!!!!!!!!!!!!!!!!!!!!!!

I'm torn, because I believe this research to a certain extent, but I also believe that cancer is caused by environmental exposures, which are studied by agencies like the Silent Spring Institute. So reality is probably that there is a combination of factors: genetics, diet, environmental exposures, and probably other factors, all contributing to cancer risk.

So what is a person to do?

I'm not sure... but I need to give our diet some more thought. Stay tuned...

Sunday, December 02, 2007

A little public health - part 2

In my last public health post, I talked about the fallacy that abortion increases a woman's chance of getting breast cancer. This time, I want to talk about the fallacy that all women, or most women, who have an abortion, later regret their decision.

Now, I'm sure that some women who have abortions do regret their decision. (I'm also sure that some women who have kids regret their decision, but that's a post for another day....)

But if you look on the Internet, searching Google on, say "abortion + regret", you will see a LOT of misinformation on this topic. This
enrages me. The Internet is a great place, but for certain topics, it's much easier to find misinformation than correct information. And abortion is one of these topics.

So let's take a look at what the Internet has to say about abortion and regret, shall we? Here are the Google search results:

1.
Takes us to Abortion and the Regrets: It reads: "This page contains stories from women who have had an abortion, regretted the decision, and requested that their story be posted on this web site. The purpose of this page is to show that women are not always informed properly and that abortion is not necessarily the best the solution. "

2.
Takes us to The Silent No More Awareness Campaign. It reads:

Welcome to the Silent No More Awareness Campaign website...Silent No More Awareness is a Campaign whereby Christians make the public aware of the devastation abortion brings to women and men. The campaign seeks to expose and heal the secrecy and silence surrounding the emotional and physical pain of abortion.

3. Takes us to After Abortion.com

So you've had an abortion... Think you're alone? Think again. By age 45, 1 out of every 2.5 women in the United States has had at least one abortion!Who are these women? They are single women, married women and divorced women. They are your sisters, your cousins, your aunts, your mothers, your neighbors, your co-workers, your schoolmates, they are women you see every day when you go out into the world...So with all these women undergoing this common medical procedure, why isn't there more support for women after an abortion, to discuss their experience? Why so few support groups to talk about your physical and emotional issues afterwards? The fear of political or religious backlash, and the fear of negative reactions from friends or family keeps most women from discussing anything they feel after their abortion. This website provides a neutral, non-political, non-religion based, non-judgmental place for women to communicate with each other after an abortion.

4. Takes us to "HolyWeb.com" which gives us some information on the stages of grief as well as some
religious advice

5. Takes us to SteadyHealth.com which informs us that "research" shows that abortion regrets last for years

This is just a sample of what you find on the Internet. Of the 5 sites that I found chronologically on Google, only one of them (#3) is anywhere near useful. I find this not only infuriating, but scary. People rely on the Internet for information, and on this topic (and many others, I imagine), real information is scarce.

After taking a look in PubMed, which, as I explained before, is a place to find peer-reviewed research, I was surprised to find research articles about both miscarriage and abortion when I did a search of "abortion." In PubMed, miscarriage is "spontaneous abortion" and abortion is "induced abortion." (As a side comment, there are quite a number of studies showing the adverse psychological effects of miscarriages, which are far more common than abortion... but that is also a topic for another day.)

In any event, I found an article that seemed useful. It is from the Journal of Advanced Nursing from 2000. This article is entitled "Psychological responses of women after first-trimester abortion." Here is the abstract:

BACKGROUND: Controversy exists over psychological risks associated with abortion. The objectives of this study were to examine women's emotions, evaluations, and mental health after an abortion, as well as changes over time in these responses and their predictors. METHODS: Women arriving at 1 of 3 sites for an abortion of a first-trimester unintended pregnancy were randomly approached to participate in a longitudinal study with 4 assessments-1 hour before the abortion, and 1 hour, 1 month, and 2 years after the abortion. Eight hundred eighty-two (85%) of 1043 eligible women approached agreed; 442 (50%) of 882 were followed for 2 years. Preabortion and postabortion depression and self-esteem, postabortion emotions, decision satisfaction, perceived harm and benefit, and posttraumatic stress disorder were assessed. Demographic variables and prior mental health were examined as predictors of postabortion psychological responses. RESULTS: Two years postabortion, 301 (72%) of 418 women were satisfied with their decision; 306 (69%) of 441 said they would have the abortion again; 315 (72%) of 440 reported more benefit than harm from their abortion; and 308 (80%) of 386 were not depressed. Six (1%) of 442 reported posttraumatic stress disorder. Depression decreased and self-esteem increased from preabortion to postabortion, but negative emotions increased and decision satisfaction decreased over time. Prepregnancy history of depression was a risk factor for depression, lower self-esteem, and more negative abortion-specific outcomes 2 years postabortion. Younger age and having more children preabortion also predicted more negative abortion evaluations. CONCLUSIONS: Most women do not experience psychological problems or regret their abortion 2 years postabortion, but some do. Those who do tend to be women with a prior history of depression.

So these researchers followed a fairly large group of women from the time before they had an abortion to 2 years after the abortion. What they found is that MOST of the women were satisfied with their decision, and MOST of them said that they would have the abortion again (I assume this means that they don't regret their decision). Most of them felt that there was more benefit than harm from their abortion, and most were not depressed.

The researchers did find that some women did experience depression, and a small number had posttraumatic stress disorder, which is not unreasonable. They conclude that most women do not have psychological problems, but some women, especially those with a prior history of depression, do have some problems.

These findings make sense to me. The bottom line is: some women do regret their abortion decision; most women don't. Some women do experience depression and other psychological impacts after their abortion; most women don't. What drives me crazy is all the misinformation on the Internet that says that MOST women have regrets, MOST women have psychological problems, etc. I'm not sure what the solution is, but I certainly hope that women looking for good advice in this area don't turn to the Internet for it.

A late addition to this post: some interesting info on this topic from ReligiousTolerance.org