New Years’ is an exciting time to start fresh with a clean slate and a clear head. The concept makes sense, especially if you envision January at the top of a 2020 calendar with 2019 out of sight and out of mind. Supposedly, 60% of Americans feed into this same theme around the New Years’ holiday, around which time they set out to create and execute a list of resolutions. But how many people walk away from this feat feeling accomplished? Statistics show only about 8% of people achieve their resolutions.

 Why is this, and how does this relate to diet? As dietitians, we see and hear this a lot, no matter the time of year. People often set out to eat healthier, snack less, or cut out a specific food/food group, often overnight (such as the night of NYE) and vow to practice that resolution “forever”. The problem with resolutions and plans for permanent “clean eating” is that at the first sign of a slip-up – eating a treat you promised yourself you wouldn’t, failing to eat a salad for lunch, or going out to eat and indulging in something you know isn’t healthy – people experience an insurmountable wave of guilt that (most often) causes a subsequent binge on the previously forbidden food or other foods that are not a part of a generally-recognized healthful diet. It’s human nature. It’s the mindset of “welp, I already cheated so I might as well get my fix of this sweet/carb/snack before I cut them out completely tomorrow .” And the cycle continues.

This year instead set you up for success! To do this, trade in the list of resolutions for specific, measurable, attainable goals. The difference between a resolution and a goal is often the “measurable” aspect. Rather than resolving to “eat healthier” in 2020, make it a goal to pack a healthy lunch 4 days a week for each week in January. Another goal might be to go for a 30-minute walk outside 3 times a week or go to the gym 2 times a week in February.

 Another way to improve your chances of success this year is to focus on one goal per month. Writing out a list of ten things that you want to do better starting in January only sets a person up for failure; that’s too many habit changes to keep track of for 52 weeks straight. Rather, choose between 4-12 healthy, measurable goals and set out to focus on one at a time, assigning one goal per month for as many months as you choose in 2020. Trust me, you’ll end each month feeling like a champion if you’re able to conquer one new habit for even most of the month.

 

Here are a few goals we recommend in the new year, and beyond:

January: Get 8 hours of sleep, 5 out of 7 nights a week

February: Lift at the gym 3 days per week, cardio 2x per week

March: Complete weekly meal prep all 4 Sundays of the month

April: Train weekly to achieve 10 unassisted pull-ups by the end of the month

May: Practice “Meatless Monday” all 4 Mondays of the month

 June: Hike at least 40 miles between scheduled backpacking trips this month

 

TRHS Blog Post: Cervical Cancer Awareness Month

January is cervical cancer awareness month. Here’s to not just a month or a year, but a lifetime of a healthy cervix! How can women advocate for their own cervical health?

1. Routine pap smear and follow up if abnormal
2. Stop smoking
3. Immunize against human papilloma virus (HPV)

All three of these are really equally important. Let’s break each of them down:

Routine Pap and HPV testing: (and follow up for abnormals!)

There are 12,800 new cases of (and 4200 deaths) cervical cancer each year in the United States.^[1]

This is a largely preventable cancer! How can it be prevented? Routine pap testing!

When was your last pap smear? Are you due?

Screening with Pap testing is recommended starting at age 21 every 3 years. Once a woman turns 30, she can have Pap and HPV testing (referred to as “co-testing”) every 5 years. Women with normal screening may consider stopping testing after age 65, but only after reviewing their individual testing history with their primary care provider. Pap testing is safe during all stages of pregnancy.

With any abnormal test results, follow up intervals are shorter and there are clear guidelines that your provider will use to make sure you have the care you need. Remember, “abnormal” does not mean “cancer”. Abnormal pap smears happen often – six out of ten women will have an abnormal pap smear in their lifetime. And about 70-80% of women will clear high risk HPV infection within 3 years.^[2] Doctors, nurse practitioners and physician assistants think of pap smear results in a spectrum – abnormal results can come back as “ASCUS” (some atypical cells but unclear why), “LSIL” (low grade changes to most cells, usually due to HPV), “HSIL” (high grade changes, most likely due to HPV) or “AGC” (atypical cells from the cervical canal or uterus, not due to HPV).

Of these, the result most concerning for pre-cancer is HSIL, but all of them need follow up with your provider.

Tobacco cessation:

If you smoke, you take longer to clear the HPV virus, and you’re less likely to clear it in general. Smoking absolutely increases the risk of cervical, vulvar, vaginal cancers in women.^[3] (As well as many other types of cancer we won’t discuss more in this post!)

Immunize!

Almost all (99.7%) cervical cancer is due to HPV. The virus is transmitted by skin to skin contact (has even been found under fingernails…). Most sexually active people will have HPV at some point in their lives, even if they only have one partner. Fortunately, a large majority of people will clear the infection on their own.

Not all types of HPV cause cancer. There are high risk and low risk types. Thirteen of the more than 100 types of HPV are high risk and known to cause cervical cancer. Majority of cancer is due to types 16 and 18. About 15-30% of women will have high risk HPV in their lifetime.

High risk HPV is also involved in 72% of oropharyngeal (mouth and throat) cancers (61% is HPV 16).  The virus is also found in other types of cancer: tonsillar, base of tongue, penile, anal, vulvar, vaginal. HPV also appears to be on the rise, and the prevalence of high risk types 16 and 18 is higher in males than in females per the Centers for Disease Control (CDC).

Can high risk HPV be prevented, too? For boys and girls? Yes, read on!

The HPV vaccine covers the most common types of high risk HPV (16 and 18) seen in >70% of cervical cancer. However – it doesn’t stop there, it also covers seven other high risk types, making it a 9-valent vaccine. It can be given in 2 doses (6-12 months apart) for boys and girls under 15, and 3 doses for children over 15 or who had two doses less than 6 months apart. Vaccinating early starts cancer prevention earlier, and means less shots for your child.

Dietary Considerations: B6, B12, Turmeric, Green Tea

Recently, I attended the ASCCP (American Society for Colposcopy and Cervical Pathology) meeting in Tampa, FL. A couple of lecturers there mentioned the above natural ingredients may have a part in decreasing risk of cervical cancer, but there’s much more to study and we do not know too much to routinely recommend this as a way to prevent cancer.

Remember, the best way to prevent cervical cancer is pap testing!

Healthy Sexual Relationships:

Safer sex with barrier contraceptive can reduce, but not eliminate the chance of HPV transmission. Condom use 100% of the time only recedes HPV transmission by 70%.  As noted above, even people with only one sexual partner in their lifetime are at risk for HPV, but certainly the risk increases with more sexual partners.

So, in summary – prevention is worth a lot when it comes to cervical cancer – it’s life saving! Cervical cancer is a very preventable cancer with routine pap screening, and risk can further be brought down for future generations through the HPV vaccine, approved for young men and women ages 9 to 26.

Wishing a healthy 2019 to all.

Dr. Cara Sullivan

^[1] American Cancer Society, Cancer Facts and Figures 2017. Atlanta: American Cancer Society 2017.

^[2] ASCCP Conference, 2018. Epidemiology of HPV and Cervical Cancer. Schiffman, Castle et al. Lancet. 2007.

^[3] Giuliano AR et al. Cancer Causes Control. 2002; 13:839-846.

 

Election Day is Tuesday, November 6. 

Too many Idahoans don’t vote because they aren’t sure how to register, or moved and don’t know where to vote at their new address. Join your fellow Idahoans in getting ready to vote!

 

Vote by mail (request “absentee ballot”)

• Anyone already registered may request an absentee ballot.
• Fill out this form and send or take to your county clerk’s office. (See clerk listing on the form)
• Deadline for the clerk to receive your form is Friday, October 26.
• Once received, the clerk will mail a ballot to you. You must send your ballot back for the clerk to receive it before November 6.
• Absentee ballots may also be hand-delivered to the clerk’s office on Election Day if you forget to mail it in.

 

Vote early – in person

• Your county may provide opportunities to vote early, typically at a city or county building.
• Contact your county clerk for local options. 

 

Pre-register to vote
The deadline for pre-registration was October 12. But don’t worry, Idaho has “same day” registration!

 

Same day registration – Register on Election Day (Nov. 6)

• Find your polling place: Where do I go to vote?
• Go to your polling place between 8 am and 8 pm to vote.
• Bring photo ID and proof of residence, such as a utility bill that shows your street address. 
• Vote!

 

Not sure if you are registered or if your address is correct?
Idaho Votes website: Online registration. 
You can take a look and make updates.

 

Find out where to vote
Idaho Votes website: Where do I go vote?

 

Get set now, and get ready to vote on Election Day – Tuesday, November 6!

October is National Breast Cancer Awareness Month. Breast cancer affects one in eight women during their lifetime and according to the Centers for Disease Control, 1,170 cases of breast cancer were reported in Idaho in 2015. There is not one specific cause but scientists do know that mutations in BRCA1 or BRCA2 genes can greatly increase one’s risk of developing breast cancer.  If a family member has had breast or ovarian cancer, you may be more likely to have inherited one of those mutations. Other risk factors include obesity, hormone replacement therapy, birth control pills, alcohol intake, or having dense breasts. Additionally, your risk of developing breast cancer, as with any other form of cancer, increases with age. It is very treatable if detected early, so monitoring your breasts is imperative. You can, and should, begin performing self-breast exams at an early age. Please notify your doctor if you notice any of the following:

• Change in shape or size
• Discharge from the nipple
• Dimpling of the skin
• Inversion of the nipple
• Lumps in the breast of any size

Annual pelvic exams, beginning around the age of 21, include a clinical breast exam by a provider. Finally, it is recommended that all women get breast imaging, known as a mammogram, beginning at age 40, and every one to two years thereafter. Women with a family history of breast cancer or a known BRCA mutation can begin mammograms before the age of 40 to promote early detection. www.nationalbreastcancer.org is an excellent resource with information and ways you can contribute to the health of women across the country and the research being done to further the scientific knowledge about this disease.