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Anemia: Is Your Blood Tired?

Anemia: Is Your Blood Tired?

Hardly a novice runner, Allison was working hard to improve her distance and run a half marathon…without success. After only a few miles, she felt extremely tired and had to stop and walk for a few minutes. As her frustration mounted, a running friend suggested that she see a doctor. “Sounds like anemia to me,” the friend said. And it was. With some iron supplements, her training is back on track.

Anemia has been called tired blood, and fatigue is the most common symptom. The cells of the body need oxygen, and this is delivered to them by the iron-rich hemoglobin which attaches itself to oxygen in the lungs and travels through the body in red blood cells. When there is a shortage of red blood cells, there is a shortage of oxygen in working cells, and the result is anemia. There are about 400 types of anemia, but there are three main causes: 1) loss of blood, 2) lack of red blood cell production and 3) destruction of large numbers of red blood cells.

BLOOD LOSS: The loss of red blood cells through bleeding is common, and women of child-bearing age are vulnerable, particularly if they have heavy periods.

Heavy use of aspirin, ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs)–common among endurance athletes–can cause gastrointestinal bleeding, including ulcers.

Rapid blood loss can occur following surgery, childbirth or a ruptured blood vessel. Gradual, chronic loss because of ulcers or heavy menstrual bleeding is more common and can be equally dangerous because the symptoms are more subtle and may go unnoticed.

When blood loss exceeds production of red blood cells, the result is often iron-deficient anemia–by far the most common type.

LACK OF RED BLOOD CELL PRODUCTION: Iron deficiency anemia can also occur because of diet. Without enough foods rich in iron, folate and vitamin B12, the body is hampered in its effort to create sufficient healthy red blood cells.

A substantial portion of the iron in most of our diets comes from meat; as a result, vegetarians and vegans are at risk. There are, however, plenty of non-meat sources of iron: dark green, leafy vegetables; beans; lentils; dried fruits; nuts; and iron-fortified cereals.

Folate is found in these foods plus citrus fruits and juices and fortified breads and cereals. Vitamin B12 is found naturally in dairy products and is often added to cereals and soy products.

Iron-deficiency anemia can occur because of the extra demands placed on the body by pregnancy, breast feeding or high-level endurance training. Chronic diseases that affect the body’s ability to produce red blood cells include cancer, HIV/AIDS, rheumatoid arthritis and kidney disease.

DESTRUCTION OF RED BLOOD CELLS: Hemolytic anemia occurs when red blood cells are prematurely destroyed and removed from the system. Cells die at a pace faster than the bone marrow can replace them.

Hemolytic anemia is often associated with an autoimmune disorder in which the spleen mistakenly traps and destroys healthy blood cells.

One of the most severe forms of hemolytic anemia occurs when a person receives a transfusion of blood of the wrong blood type. Existing red blood cells produce antibodies to fight the transfused blood, causing extremely rapid destruction. A newborn can develop this type of hemolytic anemia when the mother and child have incompatible blood types.

Sickle cell anemia is an inherited disorder in which red blood cells form an abnormal crescent shape that causes them to get stuck in tiny blood vessels and break down prematurely. This disorder affects mainly African American and Hispanic Americans.

WHAT TO DO: Whether because of diet, destruction or blood loss, the bottom line is blood that does not contain enough red blood cells and hemoglobin to nourish the tissues of the body. In addition to fatigue, symptoms can include weakness, pale skin, cold hands and feet, shortness of breath, dizziness and a fast or irregular heartbeat.

All of these are symptoms of other common ailments, so a visit to your doctor and a complete blood count is needed to confirm a diagnosis. In some cases, the patient may have symptoms too mild to be noticed, especially at first.

In many cases, treatment is simple: a change of diet plus iron and other supplements. If a medical condition or illness is responsible for the deficiency, then the underlying cause must be identified and treated.  Visit your doctor to get more information.  Don’t have a doctor?  Visit http://www.affinityhealth.org/Affinity/Find-a-Doctor.htm to find one closest to you.


Breast Cancer: A journey of innovation

October is Breast Cancer Awareness Month. While it is certainly a scary diagnosis, there’s so much hope. It’s exciting how much progress has been made in the treatment of breast cancer in recent years.

First surgical successes

The first major surgical advances came in the 1970s when research showed there was the same survival rate for women who underwent breast preservation using lumpectomy (surgical removal of tumor[s] in the breast) and radiation, as there was for women who had a mastectomy (complete removal of the breast).

More surgical options for women

This discovery, along with rapid developments in breast reconstruction, opened a whole new avenue of surgical options for women. No longer were women faced with a body-altering mastectomy as their only choice of treatment. Breast biopsies also started to become to become less invasive, as the need for an operating room procedure was steadily replaced by image-guided needle biopsies. Continue Reading »

Recipe: Pumpkin Butter

Recipe: Pumpkin Butter

Apple butter, maple-flavored butter and others are delicious toppings to toast, waffles and other breakfast fare. This fall, why not try making pumpkin butter. This delicious and nutritious recipe also includes warm spices like ginger, cinnamon and cloves. Makes 3 3/4 cups (original recipe here).


  • 3 1/2 cups pumpkin puree, or 1 (29 ounce) can of pumpkin puree NOT PUMPKIN PIE FILLING
  • 2 tsp vanilla extract
  • 3/4 cup apple cider or juice
  • 1 cup packed brown sugar
  • 2-3 cinnamon sticks
  • 1-2 tsp pumpkin pie spice mix (see below to make your own and save money)

Pumpkin pie spice mix

  • 3 tablespoons ground cinnamon
  • 2 teaspoons ground ginger
  • 2 teaspoons ground nutmeg
  • 1 ½ teaspoons ground allspice
  • 1 ½ teaspoons ground cloves

Mix together and store mix in a clean small jar.


  1. Combine pureed pumpkin, vanilla, apple juice, spices, cinnamon sticks and sugar in a large saucepan; stir well.
  2. Bring mixture to a boil.
  3. Reduce heat, and simmer for 30 – 40 minutes or until thickened.
  4. Stir frequently.
  5. Adjustspices to your taste.

Nutrition Information
Servings: 30; serving size: 2 tbsp

  • Calories: 32
  • Fat: 0.1 g
  • Protein: 0.5 g
  • Carbohydrate: 9.5 g
  • Fiber: 1.3 g
  • Sugar: 8 g
  • Sodium: 3.5 g

Submitted by Julia Salomon, nutrition educator and corporate dietitian. Photo from Skinny Taste blog post.


Exercise: Moderate or Vigorous?

Exercise: Moderate or Vigorous?

Several decades ago, when running was first gaining favor as a healthy habit, there was much talk of LSD, or long slow distance, as a training strategy. The idea was that jogging 8 to 10 miles at a slow pace built stamina and a training base. Even then, of course, most trainers advocated some combination of slow and fast paced workouts each week for building aerobic fitness.

Today, the operative term is “fat burning.” Actually, intense exercise is more efficient at burning fat, but there is no question that if you walk or jog eight miles, you will end up burning more calories than if you run two miles at any speed. If weight loss is your goal, you are probably better off moving at a pace that you are willing and able to sustain for a longer period. But how about fitness and health? Is strolling as beneficial as brisk walking? Is walking as beneficial as running?

The American Heart Association (AHA) recommends 150 minutes a week of moderate physical activity, 75 minutes a week of vigorous activity or some combination of the two. As defined by the AHA and the American College of Sports Medicine, moderate exercise is not just a stroll in the park but activity that feels at least somewhat hard. For most persons, depending on fitness level, this is a walking pace of 3.0 to 4.0 miles per hour. You should be breathing faster than usual but not so fast that you’re out of breath. You can talk and carry on a conversation, but you can’t sing. And you’ll break out in a light sweat after about 10 minutes.

Vigorous activity, on the other hand, should feel challenging. Your breathing is deep and rapid, and you can’t say more than a few words without catching your breath. You are likely to start sweating after only a few minutes and may feel drenched by the time you’re finished. If you are wearing a heart rate monitor, moderate exercise means a heart rate of 50 to 70 percent of your maximum compared to 70 to 85 percent for intense exercise. As a rule of thumb, maximum heart rate equals 220 minus your age (180 for a 40-year-old). Whichever intensity level you choose, the benefits to the cardiovascular system are well documented. If you consume a thousand calories a week through physical activity, you are 20 percent less likely to die of any cause compared to a person who does not work out. This amounts to walking an hour a day five days a week.

Athletes and athletic trainers know the value of intensity in developing aerobic capacity and athletic performance. But is vigorous exercise–and fitness–really more beneficial to the heart and cardiovascular system?A 2006 article reviewed not only epidemiological studies but also clinical trials that trained subjects at different levels of intensity. Since vigorous exercise consumes more calories per minute of activity, the authors included only studies that controlled for energy expenditure. The pattern in all of these studies was clear: exercise at greater intensity provided greater protection against coronary heart disease.

For each one-MET increase in aerobic capacity, the researchers found an 8 to 17 percent reduction in the risk of death from cardiovascular disease or any other cause. MET stands for metabolic equivalent; one MET equals the energy used while sitting at rest; six METS, the energy required for jogging at 6.0 miles per hour.

Other observational studies have reached different conclusions. Some have concluded that moderate exercisers tend to be healthier–perhaps because they are moderate in other behaviors as well. A long-term study of Harvard alumni found better cardiovascular health in persons who burned the most calories–regardless of intensity. There is always a trade off. If your intensity level is too high, you run the risk of injury…and burnout. At a moderate level, you’re going to have to work out longer or more often to burn the same number of calories.

Age and health also enter the picture. Even survivors of heart attacks need to exercise, but usually under controlled conditions and monitoring in a cardiac rehabilitation facility.

The primary goal of the American Heart Association is to encourage regular physical activity. There is no question that exercise is a healthy habit, regardless of intensity. The best exercise is what you can and will do…day after day and week after week.  To learn more about setting up an exercise plan that works for you, talk to your primary care physician.  Don’t have a primary care physician?  Visit http://www.affinityhealth.org/Affinity/Find-a-Doctor.htm to find one nearest you.

Eating Well To Power Your Brain

Eating Well To Power Your Brain

The brain is a powerful operating system, tasked with filtering incoming information, making split second decisions, retrieving information from our memory banks and controlling both our conscious actions and autonomic body functions when we’re awake and asleep. Representing just two percent of the body’s mass, the brain is power hungry, requiring more than 20 percent of the body’s calorie intake. We’ve long known that what we feed our bodies has a major impact on our physical health. What is becoming increasingly clear is the link between what we eat and brain health as we age. Scientists are moving toward the belief that what’s good for the heart is also good for the brain.

A study of rats fed a diet high in cholesterol and saturated fat found that, compared to a control group, those on the high fat diet showed negative effects on memory and other brain functions. This seems to be also true for humans. A study at Brigham and Women’s Hospital in Boston [Annals of Neurology], found that women who reported eating the highest levels of saturated fat from red meat and butter performed worse on tests of thinking and memory than women who ate the lowest amounts of saturated fat. This raises the question: if a high fat diet is bad for the brain, can healthy eating make a difference?

Research is now focused on the effects of antioxidants on the aging brain. Oxidative stress, the build up of free radicals in the brain over time, is believed to play a role in the development of Parkinson’s disease and Alzheimer’s dementia.A laboratory study designed to determine the role of antioxidants in brain changes associated with aging, fed rats a blueberry rich diet. Older rats eating a blueberry-rich diet performed comparably to younger rats on tests of memory and better than the older rats eating a regular diet. Another study found positive results in women eating an antioxidant rich diet. A group of women who ate two or more servings of blueberries and strawberries daily were able to delay the effects of memory decline by two and a half years compared with a control group. A study, published in Neurology [May, 2015] monitored the eating habits of 27,860 men and women in 40 countries over a five year period. Subjects reported on their food intake and completed tests of thinking and memory at the beginning of the study and after two and five years.

Researchers found that those who ate the healthiest diets were 24 percent less likely to show cognitive decline compared with those with the least healthy eating habits. The healthiest eaters tended to be slightly older, more active, less likely to smoke and to have lower BMIs. While saturated fats and trans fats appear to be bad for both the heart and the brain, the brain is dependent on healthy fats to carry out multiple brain and nerve functions. Omega 3 fatty acids, believed to improve memory, can be found in fatty fish such as salmon, Bluefin tuna, sardines, herring, fish oil supplements, seaweed, walnuts, and pumpkin and flax seeds. Omega 6s, more plentiful in the typical American diet, can be found in corn, soybean and sunflower oil as well as nuts and seeds.

Although scientists still lack definitive proof for a brain healthy diet, the evidence is mounting in favor of a number of healthy choices.

Blueberries and other dark colored berries such as blackberries, cherries, acai and goji berries are high in antioxidants and flavonoids.

Beans and legumes are rich in folate, a B vitamin associated with brain health. They are also a source of omega fatty acids.

Dark green leafy vegetables such as kale and spinach are good sources of folate and vitamin E to help prevent damage to DNA.

Tomatoes are a good source of lycopene, a powerful antioxidant.

Nuts are nutritional powerhouses and a good source of vitamin E.

The Mediterranean diet brings together many of these separate elements into an eating plan that is relatively easy to follow. This diet focuses on fish at least twice a week, limited red meat, olive oil instead of butter, with a focus on fruits, vegetables and whole grains. Although there’s no absolute proof, the Mediterranean diet is associated with lower levels of mild cognitive impairment and Alzheimer’s disease.

A healthy diet might just provide us with the ultimate win win scenario…providing nutrition that is good for the aging brain as well as the heart. Talk to your primary care physician to assist setting up a proper diet.  Visit affinityhealth.org to find a doc nearest you.

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