Women’s Health News Round-Up: November 15, 2013


This week’s news round-up focuses on health events and new or revised health resources.  What’s included?  A New York Times article about the question of why Americans weigh more now than we did 40 years ago, Diabetes Awareness Month, lesbian/bi/queer women and STI risk, and the relative benefits of HPV vs. pap screening.

Gut bacteriaWhy do Americans Weigh More Now than We Did 40 Years Ago?
For many people it seems clear that the “obesity epidemic” (a phrase we don’t particularly like) is due to bigger portion sizes and less physical activity.  However, a recent article in the New York Times explores one of the many alternative factors with which those in the Health At Every Size® (HAES®) community are very familiar – changes in the gut bacteria that helps us digest carbohydrates, provide vitamins, and regulate how much fat our body stores.  Click here to read the article.

National Diabetes Month 2013November is Diabetes Awareness Month!
Diabetes affects nearly 26 million Americans and an estimated 79 million people are at risk for developing the disease. In observance, the National Diabetes Education Program (NDEP) and its partners are working with individuals, families and communities to take action and encourage simple, but important lifestyle changes to improve their health – particularly if they have diabetes or are at risk for the disease.  Diabetes is definitely a preconception health issue as uncontrolled, both Type 1 and Type 2 diabetes raises the risk of problems for the baby and the mother.

While the NDEP is focusing on prevention, the American Diabetes Association, which sponsors the event, is focusing on raising awareness that diabetes is a condition that affects people who have it on a daily basis.  They are inviting people with diabetes to share their photos and stories of living with the disease on Facebook as part of their “Day in the Life of…” campaign.

At Go Folic! we are always interested in healthy food.  What to cook if you have diabetes? You can download “Tasty Recipes for People with Diabetes and Their Families” by clicking here (PDF – 1 MB).

Lesbians in love - still from the Taiwanese film, Spider Lilies"Are women who have sex with women at risk for getting STIs?
The Womenshealth.gov website recently updated their health fact sheet for lesbian and bisexual health women, which provides a whole section on STI risk among women who have sex with women.  In addition to impairing fertility, untreated STIs – including some that are more likely to affect queer women,  can affect a developing fetus and raise the risk for preterm birth.  Access the health fact sheet here.

a doctor talks to her patientHPV Screening vs. Pap Smears
Finally, a new study published in the Lancet suggest that screening for the human papillomavirus (HPV) is more effective than Pap tests for protecting women against invasive cervical cancer.  This is life-saving news for the 12,340 who are diagnosed with the condition annually.  Get the full story here.


Why aren’t we all talking about Renisha McBride? Racial Injustice as a Public Health Issue


Go Folic! usually steers clear of controversy.  So why I am writing this post, especially as I am one of only two regular contributors to this blog? As a white woman who is concerned with women’s well-being and who works in the field of public health, I feel compelled to speak out to ask my other white colleagues to follow suite.

Who is Renisha McBride?

Renisha McBride funeral coverAt about 2:30 AM on Saturday, November 2, Renisha McBride got into a car accident in her home neighborhood of Dearborn, Michigan. She decided to knock on the door of a nearby house in order to seek assistance.  After being refused help, she began to walk away. It was then that the 70-year old homeowner shot her in the back of the head with a rifle, claiming that he feared for his life.

As many of her advocates have pointed out, if Renisha had been white and the elderly man who shot her had been black, the shooter would have been jailed and the national news machine would have picked up on this story immediately.  But Renisha was black, and the shooter was white. It’s Sunday morning now, and this story is getting more coverage in the mainstream press . However, early on, one of the only non-black national news sources to cover the story was Salon.com (thank you, Joan Walsh).

I am a progressive news junkie – a day doesn’t pass when I don’t listen to KPFA, watch the evening news, and peruse the headlines of the New York Times.  The fact that it took almost a full week for me to learn about Renisha’s death – via a Davey D interview on Hard Knock Radio with filmmaker Dream Hampton – says much about the state of racism and racial injustice in America.

Theodore Paul Wafer, the man who used such force when he shot Renisha that her family was unable to hold an open casket funeral, cited Michigan’s “Stand Your Ground Law” as justification, claiming that he was afraid for his life. How one can be threatened by an unarmed teenage girl who is walking away from you is beyond me.  There can be no justification for what happened.

Why write about Renisha McBride on a health blog?

Within public health circles, it is well known that African-American women are two to three times more likely than white women to give birth to babies that are born too small (low birthweight, or less than 5 pounds, 8 ounces) and too early (preterm, or at less than 37 weeks of pregnancy). These health disparities continue to impact the health of black women, men and children throughout the life course; poor birth outcomes predict infant mortality, as well as other adverse outcomes, from child disabilities and asthma to adult cardiovascular disease and diabetes.

When first presented with these statistics, I assumed that poverty (certainly a result of racism) was to blame.  It was overwhelming to learn that even black women who are well-educated and financially successful – in other words, women who I count among my friends and colleagues – are also at two to three times higher risk than their white peers of experiencing poor birth outcomes.

Why do these disparities exist, even when socioeconomic status is taken into account?  As Jason Silverstein so eloquently documents in a recent article in the Atlantic Monthly, “Racism is Bad for Our Bodies.” Living in a world where one not only experiences discrimination, but also must ready oneself to experience it on a daily basis creates a constant state of stress that a growing number of studies have shown to increase the risk of everything from depression, to hypertension to breast cancer and infant mortality. As Mr. Silverstein points out in his article, the problem is so pronounced and so so serious that two prestigious journals - The American Journal of Public Health and The Du Bois Review: Social Science Research on Race - dedicated entire issues to the subject.

What is a white woman’a role?

In her interview with Davey D, which you can listen to in the KPFA archives, Dream Hampton states that white women have an obligation to confront our own racism and our own fears of black people.  I suspect that many of us who work in public health would maintain that in embracing the “fight” against health disparities, we have already done so.

black dad and babyIs this actually the case?  In my fields – reproductive and Maternal, Child and Adolescent Health (MCAH) – black men are usually excluded from conversations (and program funding) involving women’s health, even though for the majority of women, they are one half of the equation.  Even worse, black men are frequently demonized as the perpetrators of violence against black women.

These beliefs clearly reflect the racial narrative that is woven into the fabric of white American culture and media, in which people who inhabit black or brown bodies are portrayed as criminals, as slaves, as victims, but rarely as full human beings.

Black folks are not a cause…

Recently, I was asked to join a community advisory board for a project that is addressing race-based health disparities.  During our first meeting, members were asked to state why we were interested in the project.  Almost every white woman at the table, myself included, said something about her commitment to “The Cause.” However, black members’ responses were women far more personal, as women talked eloquently about their own experiences and/or the real life impact of racial injustice on the health of people that they loved.

I thought about my own response long after the meeting.  Intuitively, I knew it was wrong, but couldn’t put my finger on why, despite how deeply troubling I found it.  When I sat down to write this post, it hit me – I had turned black women into a cause, an act that is  every bit as dehumanizing as acting on other racial stereotypes would be.

“It’s the Skin We’re In”

We cannot escape the skin we’re in, no matter our color.  But those of us who are white can afford to ignore its consequences.  In a study that was initially published in the January 2009 issue of the Maternal and Child Health Journal, black women of all socioeconomic backgrounds reported racism experiences during childhood, adolescence, and adulthood and vigilance in anticipating future racism events.  

The “cause” of racism I can walk away from when I leave my office if I am white. It is much more difficult to walk away from racism when I understand a problem as affecting colleagues and people I love on a daily basis.

Were I to have a daughter of Renisha’s age who found herself in the same circumstances, I would want her to be able to seek help, in whatever neighborhood she found herself.  Living in a world where one must constantly fear for one’s own life or the life of one’s children, can only intensify the health impacts of discrimination.

As one protester in Detroit pointed out to a Voice of Detroit Reporter, “I have a twelve-year-old daughter. I don’t want to hear this kind of news about her. We have a Black President, but it is still open season on us. I’ve been working since the age of 14 and have three college degrees, but people still stereotype me, following me around as I’m shopping.”

It is incumbent upon all of us who work in the health field and are white to support our black sisters in their fight to ensure an end to this “open season” on black people of all ages.  We must make repealing “Stand Your Ground” laws and “Stop and Frisk” policies a matter of public health.

Before that, If we genuinely want no more Oscar Grants, no more Trayvon Martins, no more Jack Lamar Robersons, no more Jonathan Ferrells, and no more Renisha McBrides, we must confront our irrational fears of our black (and brown) sisters and brothers
(Michael Moore’s Bowling for Columbine can be good place to start). We must refuse to feel comfortable with or to support media portrayals of black men and women as criminals, victims or causes, and examine our motives in wanting to help.  We must listen to and acknowledge the stories that black folks tell about their experiences of racism.  And we must invite our white friends and colleagues to do the same.

In Closing

________________________________________________________

Shivaun Nestor, Go Folic! CoordinatorWritten with great love and respect,
Shivaun

Thoughts? Differences of opinion?  Please comment, remembering that we reserve the right to moderate and expect that people discuss issues with respect.

Foodie Tuesday: Garlicky Sautéed Greens


This is the season for dark, leafy greens – collards, mustard, beet, kale, even cabbage!  While in Northern California, we can get dark leafy greens pretty much all year-round, they grow best in cooler weather, making fall and winter the best seasons to eat them.  For today’s recipe, we were inspired by the beautiful pre-washed braising greens that we found at the Happy Boys Farm farmers’ market stands this weekend (see our first photo).

Greens are high in so many nutrients and so tasty that we can’t help featuring them often.  They are rich in both minerals (iron, calcium, potassium, and magnesium) and vitamins (folate and other B vitamins, K, C, and E). They also provide the phytonutrients beta-carotene, lutein, and zeaxanthin, which protect our cells from damage and our eyes from age-related problems. They even contain small amounts of Omega-3 fats.

This Italian-inspired recipe would make a great addition to any Thanksgiving table, and could also be used with lightly pre-steamed broccoli.  It is one of the quickest greens recipe that we’ve published over the years.  First, it uses baby greens, which are less time-intensive.   It also uses pre-washed greens, which greatly cuts down on the prep time.  If you can’t get to a farmer’s market, consider using pre-washed bagged greens, available in many supermarkets.

Garlicky Sauteed Greens

Garlicky Sautéed Greens
Makes 6 servings
Folate per serving: between 20 – 60 mcg (5-15% RDA)

INGREDIENTS

  • 1 & 1/2 lb. mixed, pre-washed braising greens (collards, kale, mustard, beet, turnip), cut on the short side into 1-inch strips
  • 1 TBS cooking olive oil
  • 3-6 cloves garlic, depending upon taste, very thinly sliced
  • 1/4 TSP crushed red pepper, or more to taste
  • Salt to taste
  • 1/2 cup chicken or vegetable stock + more as needed
  • 1 – 2 TBS extra virgin olive oil, to finish
  • 1 TBS balsamic vinegar or lemon juice, to finish

INSTRUCTIONS:

  1. Heat oil in large skillet until warm but not smoking.  Add minced garlic and sauté until soft and slightly browned.  Be careful not to burn the garlic – it can turn very quickly. 
  2. Add crushed red pepper and stir briefly with spoon.
  3. Add a handful of greens, stirring constantly.  Add another handful of leaves as the first batch wilts slightly – continue until all greens have been added.
  4. Sprinkle with salt and pepper to taste, then stir in chicken stock.
  5. Steam greens in stock until chicken stock is absorbed and the greens are cooked through but still bright green and retain some shape (about 4-8 minutes, depending upon greens).
  6. Remove from heat, and stir in extra virgin olive oil and balsamic vinegar or lemon juice.  Taste and add more salt, if needed.
  7. Serve immediately.

Optional cooking additions: For a slightly nutty flavor, add 2-3 tbs. of toasted pine nuts before serving.  For a Sicilian twist, add 3-4 tbs. of raisins with the stock and then add the toasted pine nuts before serving.

Nutritional cooking tip: Greens need to be slightly cooked in order to absorb the iron they contain, but not cooked so long that the folate is destroyed.

Source of nutritional information: http://www.ars.usda.gov/News/docs.htm?docid=23199

Foodie Tuesday: Glazed Chicken Salad with Fuyu, Avocado & Pomegranate


Honey Glazed Chicken Salad with Persimmon, Avocado and Pomegranate

Why do we love the fall?  For one thing, fuyu (Japanese persimmons) are back in season!  While fuyu have small amounts of folate, they are big on overall nutrition.  High in fiber at 6 grams, one fruit also contains 55%  of your daily recommended amount of vitamin A and 21% of your daily minimum requirement for vitamin C, both of which are good for skin. It also has 8% of your RDA for potassium, to keep your muscles in good working order.

fuyu at the Ferry Building Farmer's MarketToday’s recipe combines fuyu, pomegranate seeds, avocado and folate-full greens with glazed chicken, for an elegant company brunch or lunch-time winter salad, one high in nutrients and bursting with flavors, both sweet and savory.  This recipe takes a little longer than many Go Folic! recipes, but it’s worth it.  Serve with a nice walnut or cranberry bread, and your favorite ice tea.

Glazed Chicken Salad with Fuyu, Avocado & Pomegranate
Prep time: 40 Minutes
Servings: 4, 155 mcg folate (38.5% RDA)

INGREDIENTSFor the honey-glazed chicken:

  • 2 boneless chicken breast halves with skin
  • 2 tbs honey
  • 2 tsp fresh lemon juice
  • 1 tbs mild olive oil
  • Coarse salt and freshly ground pepper

For the dressing:

  • 1 tbs finely chopped shallots
  • 3 tbs fresh pomegranate juice
  • 1 tbs sherry vinegar
  • 2 tsp rice vinegar
  • 3 tbs extra-virgin olive oil
  • 1 tbs hazelnut or walnut oil

For the salad:

  • 2 small Fuyu persimmons, thinly sliced
  • 1/2 cup pomegranate seeds
  • 2 cups pre-washed baby arugula
  • 2 cups pre-washed baby spinach
  • 2 cups pre-washed sweet baby lettuces
  • 1 avocado, peeled and sliced, sprinkled with lemon juice
DIRECTIONS

  1. Preheat oven to 375 degrees. Rub chicken with salt and pepper to taste, and place on a baking sheet skin side up.  Roast for 20 minutes. While chicken is roasting, stir together honey and lemon and set aside.
  2. After chicken has cooked 20 minutes, remove from oven, and discard the skin.  Spread with the lemon-honey mixture.  Return to oven and cook chicken, basting with pan juices, until meat is opaque throughout, about 15 minutes longer.
  3. Remove chicken pan from heat, and let sit in pan juices.  When cool, cut into bite-sized cubes.
  4. In a small bowl, combine chopped shallots, pomegranate juice, sherry and rice vinegars, and salt; let stand 5 minutes. Whisk in walnut and olive oils.
  5. In a large bowl, toss persimmons and chicken with dressing; season with salt, pepper, and a squeeze of lemon. Gently toss with greens.
  6. Arrange salad on a serving platter, tuck in avocado slices, sprinkle with pomegranate seeds, and serve.

Hint #1: Unlike their Western cousins, which are ripe when soft, fuyu are ripe when very firm to the touch.  And as you cut them into wedges for the salad, don’t worry about taking out the seeds – they’re edible!

Hint #2: Cut down on prep time by cutting vegetables while chicken is cooking and by using pre-seeded pomegranate seeds.

Halloween Preconception Health Tip! Love Your Teeth


Healthy Halloween Teeth?

Healthy Halloween Teeth?

October is National Dental Hygiene Month, which is sponsored by the American Dental Hygienists’ Association (ADHA).  So it only seemed logical to focus on oral health for our last post of the month.  Yes, today’s post is partially inspired by the candy that is so tempting during and directly after Halloween, not to mention the beautiful sugar skulls that are part of Dia de Los Muertos (Day of the Dead) celebrations.  But it’s also inspired by the importance of dental health for moms-to-be, both before and during pregnancy.

Sugar Skull

Click on the sugar skull for a traditional sugar skull recipe.Why is dental health important for women who might or want to get pregnant?

Brushing, flossing and regular cleaning is important for all women since problems with your teeth and gums can affect the health of your entire body. It’s even more important before and during pregnancy, including for these reasons:

  • Gum disease and other dental problems can affect the health of a pregnancy,  increasing the risk for both having a baby early (preterm) and giving birth to a baby that is too small (low birth weight).
  • The changing hormone levels that occur with pregnancy can actually make some dental problems worse.
  • If a woman’s mouth is healthy before and during pregnancy, it’s likely that her baby will be born with a healthy mouth too.  

Tips for Better Dental Health

Here are some dental health tips from Every Woman California.

  • Visit a dentist at least once a year, or as often as the dentist recommends, for cleaning, exam and protective treatments, such as fluoride and dental sealants.
  • Brush your teeth with fluoride toothpaste and a soft toothbrush at least two times every day, especially before bed.
  • Floss your teeth every day.
  • Limit foods and drinks containing sugar to mealtimes only. Don’t drink juice, soda or carbonated drinks, including diet soda, between meals. Juices and sodas contain sugar that can cause tooth decay (cavities). Even diet sodas contain acids that can weaken the outer surface of your teeth.
  • If you use chewing gum or candies, choose brands that are sugarless. Those containing xylitol are best and can help protect your teeth. Xylitol can actually help decrease the amount of harmful bacteria in your mouth that cause tooth decay.
  • Don’t smoke or use tobacco products.

What should you do if you don’t have dental insurance?

Despite the fact that a healthy mouth plays an important role in overall health, the Affordable Care Act doesn’t include dental coverage.  And dental care can be very expensive. Fortunately, if you live in San Francisco, there are many sources of free and low-cost dental care, and the San Francisco Health Plan (Healthy SF) does cover some services.  Click here for a recently updated list of low-cost dental providers from the San Francisco Department of Public Health.

How do you brush your teeth?

According to the ADHA, brushing and flossing regularly is the best thing that you can do to keep your mouth healthy.  Are you doing it correctly?  The video below provides a great “how to.” For more tips, click here to go to the ADHA website.

Foodie Tuesday: Halloween Slow Cooker Pumpkin and White Bean Stew


Slow Cooker Pumpkin and White Bean Stew

Just recently, as though to welcome Halloween, sugar pumpkins began to appear in farmers’ markets and the weather turned fall like.  In response, at Go Folic! our thoughts naturally turn towards hearty pumpkin soups and stews.

While not high in folate, this orange fall favorite packs many health benefits.  Pumpkin is high in fiber (good for digestion), the antioxidant beta-carotene (which may reduce the risk for cancer and reduce wrinkles), and the immune system booster, Vitamin-C.   One cup of pumpkin contains more potassium than a banana (crucial for heart and other muscle function).  When you cook pumpkin, save and roast the seeds, which are full of the mood booster, tryptophan and  phytosterols, shown in studies to reduce LDL or “bad” cholesterol.

Today’s recipe contains both pumpkin and folate-full white beans.  This elegant, easy-to-make vegetarian entree is a slow-cooker adaptation of a Basque recipe published in the original Greens Restaurant Cookbook by Deborah Madison.

Slow Cooker Pumpkin and White Bean Stew
Prep time: 20 minutes
Servings: 4, 160 mcg folate (33% RDA)

INGREDIENTS

  • 1/2 cup dried cannellini beans, rinsed and picked over
  • 1.5 pound pumpkin, peeled, seeded and cut into 2-inch chunks
  • 2 tbs. virgin olive oil
  • 3 leeks, white parts only, rinsed and cut into 1/4 inch pieces
  • 2 carrots, peeled and cut into 1/2 inch slices
  • 2 stalks celery, cut into 1/4 inch slices
  • 2 cloves garlic, minced
  • 1/2 tsp. dried sage, crumbled
  • 1/2 tsp. salt
  • pepper to taste
  • 4 cups vegetable stock
  • Parsley, chopped (for garnish)
  • Extra Virgin Olive Oil (for garnish)

INSTRUCTIONS

  1. Soak beans in water overnight; drain, then place in bottom of crock pot.
  2. Toss vegetables with olive oil to coat; mix in sage, salt and pepper; place vegetables on top of beans.
  3. Pour vegetable stock over all; stock should cover all ingredients.  If not, add stock to cover.
  4. Cook on low for 8 hours or high for 4 hours.
  5. Serve topped with parsley and a  drizzle of olive oil for garnish.