Article from Townsend Letter:
Lifestyle Habits That Make a Difference
by Tori Hudson, ND

Reducing Recurring Urinary Tract Infections – The Power of Water

Sometimes we get to go back to basics and simple lifestyle changes that can then make a big difference. This study in premenopausal women prone to urinary tract infections demonstrates the point.

Researchers assessed 140 premenopausal women who had at last three urinary tract infections in the previous year, and who reported a daily fluid intake of less than 1.5 liters (about 6.25 cups) of water per day.

The 70 women in the treatment group were instructed to drink an additional 1.5 liters of water each day, and the 70 in the control group were instructed not to change their typical intake.

Over the course of the one-year study, the average daily increase was 1.15 liters (about 5 cups) in the treatment group, for a daily total of 2.8 liters (12 cups). The average daily intake was 1.2 liters (5 cups) in the control group. After one year, there were 48% fewer urinary tract infections in the treatment group than in the control group. In addition to that, the number of days from the last infection to the first recurrent infection of acute uncomplicated cystitis was 55 days longer in the intervention group than in the control group (148 vs 93). The average number of days between episodes (143 vs. 85) was also better in the treatment group.

With fewer infections, this also led to 47% fewer courses of antibiotics in the intervention group than in the control group (1.8 vs 3.5).

Commentary: Approximately 60% of women will develop a urinary tract infection in their lifetime, and one in four will have a repeat infection. Urinary tract infections lead to more than 10 million doctor visits a year, and more antibiotics.

While this simple approach will not work for everyone, it is an important strategy to at least incorporate. One caution is that, for women with overactive bladder, this increased fluid intake could worsen the urgency to urinate and increase urinary incontinence.

Why does increased water intake work? What we think is that this increases frequency of flushing bacteria from the urinary tract, which means the bacteria don’t have time to attach to the bladder wall and thus the overall concentration of bacteria is reduced. I would also predict that these same results would occur in postmenopausal women.

Reference:
Hooten TM, et al, Women who get frequent UTIs may reduce risk by drinking plenty of water. Presentation at Infectious Disease Society of America, IDWeek 2017, San Diego, CA, October 5, 2017.

Greater Cardiovascular Fitness in Midlife Women Leads to Lower Dementia Risk Later

This study was done looking at 200 Swedish women (age 38-60) who underwent cycling testing that measured cardiovascular fitness. They were followed for an average of 29 years. Using objective assessments and repeat neuropsychiatric evaluations, 23% were diagnosed with dementia at a mean age of 80. Researchers compared women who had medium cardiovascular fitness at baseline to those who had high fitness levels and found that those with a higher fitness level had an 88% lower risk for dementia over the course of the follow-up years. Of those that were in the high-fitness category who were diagnosed with dementia, it developed about 11 years later compared to those with medium fitness.

Commentary: While fitness level cannot be asserted to be a causal effect, it is worth emphasizing the possibility that improved cardiovascular fitness in midlife could modify a woman’s risk and delay or prevent dementia. There are several herbs and nutrients that have shown some suggestive influence in providing neurocognitive protection, but all research should be multifactorial in this area, given the growing numbers of individuals affected. Causation, prevention, and treatments all deserve assertive research across the spectrum of issues. Related to causation: environmental exposures, stressors, diet, brief and long-term medication exposures, and genetics. Prevention: stress, nutrition, optimal sleep habits, herbal/nutrient supplements, and medications. Treatments: natural and pharmaceutical interventions.

Reference:
Horder H, et al. Midlife cardiovascular fitness and dementia: A 44 y.r. longitudinal population study in women. Neurology. 2018; March 14; e-pub

Weight Training May Reduce Hot Flashes

There are several reasons to recommend strength training to women, including postmenopausal women: weight management, preventing decline in muscle mass, bone density, and now hot flashes!! A new clinical trial suggests that it is effective for the hot flashes of perimenopause/menopause.

When it comes to exercise, some studies suggest that exercise may help reduce hot flashes, but others show no effect. The researchers of the current study randomly assigned 58 women experiencing at least four moderate-to-severe hot flashes or night sweats daily to 15 weeks of resistance training or to a control group in which the women did not change their physical activity routine. None of the women in either group were regular exercisers or had used hormone therapy for the two months prior.

The strength training workout group had a regimen of 45 minutes sessions, three times per week, which included six exercises on resistance machines and two using body weight. Women started with lighter weights for the first three weeks, then progressively increased their weights and loads. Prior to the workout regimen, the exercise group averaged 7.5 hot flashes or night sweats a day and after 15 weeks were having an average of four to five per day. There were no changes in the control group.

Commentary: I always like to see studies on hot flashes and night sweats that offer women more lifestyle options that actually can work. If one is not already engaged in regular exercise including some kind of strength training, starting with lighter loads for the first one-to-two weeks is important in order to avoid injury. There are many non-hormonal and hormonal options to relieve hot flashes and night sweats… including dietary influences, botanicals, nutraceuticals, hormones and non-hormone prescription medications. In the case of strength training, as I said in the beginning, there are other meaningful benefits as well. Other forms of exercise are also full of benefits, including decreased incidences of heart disease, type 2 diabetes, bone loss and cancer.

Reference:
Berin E, et al.Resistance training for hot flushes in postmenopausal women: A randomised controlled trial. Maturitis. 2019; 126:55-60.

How Many Steps It Takes to Live Longer

Most all of us are familiar with the concept that we need 10,000 steps per day to achieve health benefits. A recent study was done to investigate further the optimal number of steps daily, as well as intensity required for health benefits. This observational study was conducted in 16,700 women with a mean age of 72, who used accelerometers for at least 10 hours daily for several days at the entry into the study. Women were assessed annually over a follow-up period of 4.3 years. Lower mortality was associated with more daily steps, with a median of 5,500 steps daily. Compared with the women who were the least active, about 2,700 steps per day, women in the range of 4,400 steps daily had a 46% lower all cause mortality and women who recorded about 5,900 steps per day had a 53% lower mortality. The women in the highest step group, about 8,400 steps per day, had a 66% lower mortality. More than 7,500 steps per day had no added mortality benefit, and there was no association between mortality and speed of steps/walking.

Commentary: While I don’t really want to be an advocate of lowering the amount of daily steps/exercise, I do think it is important to realized that even about half the customary 10,000 steps per day has mortality benefits; and 7,500 steps per day has optimal mortality benefits. We walk more or less on any given day, due to the demands or our lives, or the excuses we concoct; but these current results are comforting and provide a good basic guideline for how to help ourselves improve our longevity. And don’t forget, walking is a therapeutic tool for depression, osteoarthritis, high blood pressure, high cholesterol, pre-diabetes, diabetes, history of cardiac disease and PMS. Plus… good for the soul, good for the planet.

Reference:
Lee I-M, et al. Association of step volume and intensity with all-cause mortality in older women. JAMA Intern Med. 2019; May 29 (e-pub).

Author bio:
Tori Hudson, naturopathic physician, has been in clinical practice for more than 35 years.She is the medical director of her clinic, “A Woman’s Time” in Portland, Oregon and the program director for the Institute of Women’s Health and Integrative Medicine. Dr. Hudson is currently adjunct clinical professor at National University of Natural Medicine, Southwest College of Naturopathic Medicine, Bastyr University, and the Canadian College of Naturopathic Medicine.

Consult your doctor before using any of the treatments mentioned in this article.

Reprinted with permission from October 2019 Townsend Letter and Tori Hudson, ND.

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