A word from Curtis Chan


Good evening San Francisco!  I hope everyone was able to enjoy the perks of folic acid awareness week.  This week was just the beginning of a new year, a year where awareness and action will be the driving force taking control of our very own health!

Today’s blog comes to us from the fabulous Curtis Chan, MD, MPH, Medical Director of Maternal, Adolescent & Child Health in SF.  Let’s here what he has to say….

  1. Importance of Folate
  • Vitamin B9, also called folic acid or folate is found naturally in some foods, including leafy green vegetables, citrus fruits, beans, salmon, and whole grains.   However, most women do not eat enough of these foods to provide the optimal health benefit of folic acid.
  • B9 is an essential nutrient for amino acid synthesis and DNA replication.  Hence, it’s particularly important during the critical first 8 weeks of pregnancy, during the critical window of early brain and spinal cord development of the fetus.
  • Compelling research showing that folic acid drastically prevented neural tube defects caused the US Preventive Services Taskforce and the National Academy of Sciences (1996) to recommend daily consumption of 400 mcg of folic acid.
  1. Study Findings
  • In July 2014, the American College of Obstetricians and Gynecologists (ACOG), the main professional organization for OB-GYN physicians, published in its highly reputable peer-reviewed scientific journal, Obstetrics and Gynecology, a research article from Harvard Medical School, “Maternal pre-pregnancy folate intake and risk of spontaneous abortion and stillbirth.”
  • The study showed that the risk of miscarriage (or spontaneous abortions) was 20% lower among women taking high amounts of folate acid (730 ug/d) compared to those with the lowest intake (0 ug/d).
  • Since 1992, public health and medical authorities have recommended that all women U.S. Preventive Services Task Force and Centers for Disease Control and Prevention recommend that all women capable of becoming pregnant take 400 micrograms of folic acid daily to prevent neural tube defects.  While many women aren’t familiar with the brain and spinal cord deformities of neural tube defects, research has since shown other health benefits of folic acid to the mother and infant.
  • The significant risk reduction in miscarriage is another important reminder about the benefits of women taking folic acid vitamins as part of their daily routine, before becoming pregnant.

Curtis Chan, MD, MPH

Medical Director of Maternal, Child & Adolescent Health

San Francisco Department of Public Health

30 Van Ness Avenue, Suite 260b, SF, CA 94102

Foodie Tuesday is almost here!


Foodie Tuesday has returned! …Except we’re a day late…so we would like to introduce Foodie Wednesday this week!

Fall is here, but not for much longer. In nearly one month winter will have set in, and unhealthy eating & laziness will also be setting in… NOT! Wait a minute……. Just because the months of notorious unhealthy eating are creeping up on us doesn’t mean we have to let all of our hard work with our bodies go to waste. Beginning this coming Tuesday, November 25, we will provide you with yummy recipes for eating healthy throughout the cold months to come.

We wanted to warm you up this week with an overview of some of the fresh, rich in folate, produce our beautiful state of California provides us, in the fall and winter months.  california-dreaming-panoAnd to the rest of the world outside of California, all of these foods still apply to you (but you may have to be a little more creative)!

FYI: We will be using the words folic acid and folate interchangeably, like we explained two weeks ago, folic acid and folate are essentially the same, the difference is how the body recognizes it.

Dark Leafy Greens
-Spinach- 1cup= 263 mcg of folate
-Collard Greens- 1cup= 177mcg of folate
-Romaine Lettuce- 1cupe= 76 mcg of folate
Broccoli– 1cup= 24% of daily folic acid recommendation
Citrus Fruits
-Papaya- 1 papaya= 115mcg of folate
-Oranges- 1 orange= 40mcg of folate
-Grapefruit- 1 grapefruit= 30mcg of folate
Brussels Sprouts– 1cup= 25% of daily folic acid recommendation
Cauliflower– 1cup= 55mcg of folate and approx. 14% of daily folic acid recommendation
Beets– 1cup= 76mcg of folate and approx. 20% of daily folic acid recommendation
Celery– 1cup= 34mcg of folate and approx. 8% of daily folic acid recommendation
Winter Squash– 1cup= 57mcg of folate and approx. 14% of daily folic acid recommendation.

vegetables-to-grow-in-winter-640x360

Now that we are all aware of some of the folate rich produce available in the fall and winter months, we can let the information marinate until Tuesday. Make sure to stay tuned and bring your appetite next week!

Until next time, keep folicin’ San Francisco.

Weekly Health News Round-Up: October 25, 2013


In the news recently – Breast Cancer Awareness Month, youth and herpes immunity, a possible vaccine for those who already have the condition, and a new contraceptive method on the horizon.

Breast Cancer Awareness Month

Image from mammogram reminder e-card from healthfinder.govThis October is National Breast Cancer Awareness Month. About 1 out of every 8 women born today in the United States will get breast cancer at some point during her life. After skin cancer, breast cancer is the most common kind of cancer in women. While breast cancer is more common in women over age 40, younger women with a family history of breast or ovarian cancers should also talk to their doctors. And men are not immune; over 2,000 are diagnosed each year.

The good news is that breast cancer is very survivable, especially if it’s found and treated early.  Here are some tips from healthfinder.gov:

  • Your risk increases if a close family member has had breast or ovarian cancer.
  • If you are age 40 to 49, talk with your doctor about mammography.
  • Women ages 50 to 74 need mammograms every 2 years.
  • If you are male, click here to learn more about breast cancer in men from the NIH National Cancer Institute.

Your doctor can help you decide when and how often to get mammograms. Here are a list of questions to guide that discussion.  Never had a mammogram? Nervous?  Click here for a short video about what to expect.  Want to share this information with a friend or family member?  Send an e-card to show you care.

Can eating peanut butter in adolescence reduce breast disease risk as an adult?

On the prevention front, a new study published in Breast Cancer Research and Treatment suggests that eating peanut butter regularly during the preteen and teen years appears to decrease the risk of developing benign breast disease as an adult.  Click here to read more.

Growing Number of Youth Lack Herpes Simplex 1 Antibodies

holding handsAccording to a new CDC study, many U.S. teens may be more likely to get genital herpes because they didn’t get cold sores as kids.  Published in The Journal of Infectious Diseases and available online, the findings show that fewer of today’s teens have been exposed in their childhood to herpes simplex virus type 1 (HSV-1), a common cause of cold sores, than U.S. adolescents in previous years. Without these antibodies, today’s teens may be more susceptible – when they become sexually active – to genital infections also caused by the virus, particularly through oral sex. To learn more about herpes, check out TeenSource.org, as well as the San Francisco DPH City Clinic website.

Herpes Vaccines on the Horizon?

herpes virusAccording to the CDC, approximately 1 in 6 U.S. adults between the ages of 14 and 49 has been infected by Herpes Simplex Virus 2 (HSV-2), usually associated with genital infections.  A much larger number of people are estimated to be infected by Herpes Simplex Virus 1, which can result in oral or genital outbreaks. While not usually a life-threatening disease, research shows that people with herpes are two to three times more likely to acquire HIV, and that herpes can also make HIV-infected individuals more likely to transmit HIV to others.

vaccinations by injectionHowever, two vaccines currently under investigation may help to slow the herpes epidemic.  According to a report presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy in Denver, Colorado on Sept. 12, 2013, a new vaccine may reduce transmission of the virus by reducing “viral shedding” via the skin among those who already have HSV-2.  A study published in New England Journal of Medicine in January 2012, found that another vaccine was partially effective at preventing the genital transmission of HSV-1 among women.  While it had no effect on HSV-2 transmission, those women who received the investigational vaccine had fewer than half (58%) the cases of genital herpes caused by HSV-1 compared with women who received the control vaccine.  Stay tuned for more updates!

Phase 3 Trial of 1-Year Contraceptive Vaginal Ring Shows Positive Results

Nestorone 1-year contraceptive vaginal ringThe Population Council announced at the 69th Annual Meeting of the American Society of Reproductive Medicine that its 1-year vaginal ring is as safe and effective as other birth control methods that contain both estrogen and progesterone.  The Stage 3 trial involved more than 1,100 healthy, normally ovulating women across 12 study sites in Australia, Europe, Latin America, and the United States. Women who participated in the study were highly satisfied with the ring, found it easy to use, and indicated that they would recommend it to other women. The ring was also well-accepted by their partners.

According to Ruth Merkatz, Ph.D., Director of Clinical Development for the Population Council’s Reproductive Health Program, “If approved by regulatory authorities, the ring will offer a unique contraceptive option: a contraceptive that is effective for one full year, is under the woman’s control, and does not require insertion by a health care professional.”  To learn more, go to http://www.popcouncil.org/projects/115_OneYearCombVagRing.asp

Weekly Round-Up: Women’s Health News 8.16.13


In this week’s news – more benefits to breastfeeding, the wide use of withdrawal as birth control, post-partum depression among urban women, a new HIV treatment, help for smokers who want to quit, and decreases in the U.S. infertility rate.

One Third of All U.S. Women Uses Withdrawal for Birth Control
If you and a partner have used withdrawal for birth control, you’re not alone.  A new study found that up to 1/3 of sexually active U.S. women between the ages of 15-24 has done so.  While withdrawal can be almost as effective as condoms for pregnancy prevention when used perfectly, it is a very difficult method to use, resulting in a failure rate of 30%.  While many women use withdrawal when they cannot afford more effective hormonal methods of birth control, this will hopefully become less common since the Affordable Care Act requires that all insurance plans cover contraception with no co-pay.  If you are using withdrawal, it is very important to take a daily vitamin with folic acid in case you do get pregnant (see the Go Folic! website). Click here to learn more about the study.

New Moms – Breastfeeding May Reduce Your Risk of Breast Cancer!
A new analysis published in this month’s Journal of Clinical Nursing found that breastfeeding for more than six months may safeguard nonsmoking mothers against breast cancer. The same does not seem to hold true for smoking mothers, though. These findings add to the list of benefits of breastfeeding for women and their babies. Click here to learn more.

Urban Moms at Greater Risk for Post-Partum Depression
A new Canadian study found that that women living in urban centers with more than 500,000 inhabitants were at higher risk of postpartum depression than women in other areas. Postpartum depression is a serious health concern for women and their children and women who lack of social support and/or have a history of depression are at greater risk.  To learn more about the study, click here.

Thinking of Becoming an Ex-Smoker? Meditation May Help
One of the first actions doctors recommend to a woman smoker who wants to get pregnant is to quit smoking. But that can be easier said than done. A small study conducted by the University of Oregon’s department of psychology found that learning a particular type of meditation technique might make it easier for smokers to cut down, at least on a short-term basis. Mindfulness meditation is designed to help people to relax, focus on the current moment and, essentially, go with the flow of thoughts and sensations. Click here to learn more.

Good News for Would-Be Parents – U.S. Fertily Rate is Decreasing!
A couple is considered to be infertile if they have been having unprotected vaginal intercourse for 12 months in a row without experiencing a pregnancy. According to the National Health Statistics Report, the rate of infertility among U.S. couples, ages 15-44 declined between 1982 and 2010, from 8.5% to 6.0%. Click here to download the full report (PDF).

New HIV Drug Just Approved
On August 12, 2013, the U.S. Food and Drug Administration approved Tivicay (dolutegravir), a new drug to treat HIV-1 infection. It can be used to treat HIV-infected adults who have never taken HIV therapy (treatment-naïve) and HIV-infected adults who have previously taken HIV therapy (treatment-experienced). The drug is also approved the drug for children ages 12 years and older weighing at least 40 kilograms. Visit the FDA website to learn more.

Weekly Round-Up: Women’s Health News 7.26.13


This was another week full of women’s health news. If you see that we’ve missed something, please post a comment or email it to us and we will publish an addendum!

New standards for STIs screening and treatment in TeensYouth and Sexually Transmitted Infections (STIs) As reported by the National Partnership for Women and Families, Linda Carmine of the Division of Adolescent Medicine at Cohen Children’s Medical Center of New York and her colleagues provided updates on the diagnosis and management of sexually transmitted infections in adolescents and young adults, “with an emphasis on ‘what’s new’ in the field.”  The review was published in the 6/17 issue of the Journal of Pediatric and Adolescent GynecologyClick here to read a summary of the findings.

Does your reproductive health provider ask you about your stresses?Does your family planning provider ask you about the stresses in your life? A study published in the June issue of the journal, Contraception, found that, in young women who experience depression or elevated stress are less likely to consistently use hormonal contraceptive methods like the pill.  The researchers recommend that health providers address clients’ psychological and emotional status when helping them make decisions about birth control methods. Click here to read the study abstract.

What if barbie dolls looked more real than this>Barbie and Body Image – What if Barbie looked like a normal woman? It’s not exactly news that few women, if any, look like Barbie in real life.  It’s also not news that Barbie is not the best tool for encouraging healthy body image among little girls.  But what would happen if Mattel(T) modified Barbie, giving her more realistic body proportions?   One enterprising artist decided to see. Would we like her better? Would she be better for little girls’ self-esteem?  We’ll let you be the judge!  Click here to see a blonde Barbie’s before and after picture (on Upworthy)!

7 of 10 women in u.s. seek reproductive health services every year7 of 10 Women Use Reproductive Health Services A new report from the Guttmacher Institute found that 70% of U.S. women of reproductive age make at least one medical visit for sexual and reproductive health (SRH) services each year. Uninsured women are significantly less likely than either privately or Medicaid-insured women to receive SRH services. Our hope is that the provisions for women’s preventive care included in the Affordable Care Act (ACA, also known as Obamacare), will make a difference for uninsured women who are currently going without.  To read the report, click here.  To learn more about ACA requirements for women’s health care, click here.

the HPV vaccine may protect against throat cancerGet Vaccinated, Prevent Throat Cancer? A new study suggests that young women who are vaccinated against the human papillomavirus (HPV) not only protect themselves from cervical cancer, but from throat cancer as well.  HPV is responsible for up to 70 percent of oral cancers, so getting the vaccine is an important step towards keeping your throat healthy!  Click here to read more about the study.

World Population Day – Supporting Young Women


world-pop-day-infographicDid you know that…

  • Young women who avoid unintended pregnancy are much more likely to stay in school & participate in the workforce?
  • Pregnancy and birth complications are the leading cause of death among girls aged 15-19 in low-& mid-income nations?
  • In developing countries, only 22% of girls aged 15-19 who are married or in a union use contraceptives?

Today is World Population Day. This year’s theme is ending teen pregnancy.  To learn more, go to USAID at http://www.usaid.gov/what-we-do/global-health/worldpopday2013 or follow #wordpopday on Twitter https://twitter.com/search/realtime?q=%23worldpopday&src=typd.

 

In Case You Missed It! Monday’s Weekly News Round-Up


In case you missed them, here are some of the major news stories that came out regarding nutrition, vitamins and women’s health last week. We decided moved our weekly news round-up from Saturday to Monday in order to reach more people and include breaking news that comes in over the weekend.

If you’re caught in the BART strike, but on some other form of public transit, this might be the perfect way to catch up!  In the news this past week, PTSD, Hep C, battling gender violence world-wide, and some helpful new health resources from the U.S. Department of Health and Human Services (HHS).

Is someone you love a baby boomer?  Tell them to get tested for Hep C!

Baby boomers are more likely to get infected with Hep C!Hep C is a very serious form of hepititis; as the most common chronic bloodborne pathogen in the United States it is a leading cause of complications from chronic liver disease. Last week the U.S. Preventive Services Task Force (USPSTF) expanded 2004 CDC recommendations for HCV screening in persons at high risk for infection by including so including one-time screening for adults born between 1945 and 1965. The goal is to reduce confusion among healthcare providers, increase awareness of the importance of hepatitis C screening and improve testing rates—ultimately identifying millions of Americans previously unaware of their infection status and preventing the associated liver disease and deaths attributable to undiagnosed chronic HCV infection.  To learn more:

  1. Read the AIDS.gov blog post;
  2. Click here to download the full recommendations.

1 in 3 Women Worldwide Experiences Partner Abuse

Eve Ensler and Christine Schuler Deschryver interviewed by Amy Goodman

A new World Health Organization Report highlights violence against women as a “global health problem of epidemic proportions.” The report represents the first systematic study of global data on the prevalence of violence against women – experienced by 35% of all women worldwide, with intimate partner violence being the most common type, affecting 30% of all women.  Impacts range from broken bones to lower birthweight babies, pregnancy-related complications, depression, impaired social functioning and higher STD rates. The report also includes a review of how health professionals can respond to the problem.  To learn more:

  1. Visit the World Health Organization to read the press release and to download the report, as well as related documents;
  2. Click here to watch Amy Goodman’s interview of Eve Ensler and Congolese Activist, Christine Deschryver to learn about the City of Joy, a revolutionary community for women survivors of gender violence in Bukavu (written transcript also available);
  3. If you life in San Francisco, and either are experiencing intimate partner violence yourself, or have a friend or loved one who is, LEAP (Look to End Abuse Permanently) can help.  LEAP is an organization of healthcare providers and volunteers dedicated to ending intimate partner violence and family violence by establishing screening, treatment, and prevention programs in the health care setting. http://www.leapsf.org/

New HHS Tools

Person using a tablet to surf the InternetThe U.S. Department of Health and Human Services released two new tools this week:

  1. The new HealthCare.gov website will help uninsured Americans to select and sign up for health care coverage that best meets their needs.  Open enrollment begins  October 1. For Spanish speaking consumers, CuidadoDeSalud.gov will also be updated to match HealthCare.gov’s new consumer focus.  Both sites are designed to be viewed on smart phones, as well as computers and tablets.  If you live in California, Covered California (http://www.coveredca.com/) provides the same services in English, Arabic, Armenian, Chinese, Farsi, Hmong, Khmer, Korean, Lao, Russian, Spanish, Tagalog, and Vietnamese.
  2. The myfamily smart phone app allows you to set and customize health alerts and reminders so that you can better manage the health of your family.  It also allows you to keep track of past medical check-ups and vaccinations and to access health information available on healthfinder.gov.  To learn more, go to http://www.healthfinder.gov/stayconnected/.

HHS Secretary Kathleen Sebelius on PTSD Awareness Month

Posttraumatic Stress Disorder (PTSD) is a severe anxiety disorder that can occur when people experience a traumatic event.  PTSD can affect anyone – from service men and women returning from the horrors of war to abused children and the survivors of rape, domestic violence, or natural disasters. June was PTSD Awareness Month.  Secretary Sebelius issued a special statement highlighting the month “as an important opportunity to recognize and pledge ourselves to year-round support for the millions of Americans who are working to overcome this challenging and debilitating condition.”  Click here to read the full statement.