Moderate to severe menopausal vasomotor symptoms increased hip fracture risk

Women with moderate to severe vasomotor symptoms during menopause showed lower bone mineral density and higher rates of hip fracture than women without the symptoms, according to research published in The Journal of Clinical Endocrinology & Metabolism.

“Compared with women who did not have hot flashes at the beginning of the study, women who reported having hot flashes at the beginning of the study had almost double the risk of hip fractures,” Carolyn J. Crandall, MD, of David Geffen School of Medicine, University of California, Los Angeles, toldEndocrine Today. “Women who reported hot flashes also had lower bone density at the lumbar spine and the hip.”

Carolyn Crandall

Carolyn J. Crandall

Gaining a better understanding of the factors underlying these associations could inform the design of strategies that could avert fractures in women at risk, the researchers said.

“We need to determine the biological mechanisms that explain the links between hot flashes and hip fracture risk so that we can develop preventive measures to help women reduce their hip fracture risk,” Crandall said.

Using data on women aged 50 to 79 years involved in theWomen’s Health Initiative clinical trial (n=23,573), Crandall and colleagues prospectively observed associations of baseline vasomotor symptoms (VMS) with fracture incidence and BMD during an average of 8.2 years from 1993 to 2005.

The women, from 40 clinical centers across the United States, were not on menopausal hormone therapy; 4,867 women had BMD data from participating in a substudy.

The investigators measured baseline VMS, incident adjudicated fractures and BMD at baseline and four annual visits, separated by 3 years. Adjustments were made for age, BMI, race/ethnicity, smoking and education.

The HR for hip fracture among women with baseline moderate/severe VMS compared with no VMS was 1.78 (95% CI, 1.2-2.64); no association was observed between VMS and vertebral fracture. Severity of VMS was inversely associated with BMD (P=.004 for femoral neck; P=.045 for lumbar spine).

Women with moderate/severe VMS demonstrated 0.015 g/cm2 lower femoral neck BMD (95% CI, –0.025 to –0.005) and 0.016 g/cm2 lower lumbar spine BMD (95% CI, –0.032 to –0.004) than women who reported no VMS in repeated measures models.

“Hot flashes are common — experienced by at least 60% of women,” Crandall said. “We clearly have to start exploring the reasons for our findings. In the meantime, women with hot flashes may benefit from greater attention to healthy lifestyle habits to maintain bone health, such as avoiding excessive alcohol intake and smoking, maintaining adequate calcium and vitamin D intake, and getting adequate physical activity.” – by Allegra Tiver

Deficicencies in semen production linked to medical comorbidities

Researchers identified a relationship between semen production and medical comorbidities, including hypertension and endocrine disorders, according to data published in Fertility and Sterility.

“Men’s health and fertility are related,” Michael L. Eisenberg, MD, assistant professor of urology and director of male reproductive medicine and surgery at Stanford University School of Medicine, told Endocrine Today. “If one has health problems, there may be reproductive problems.”

Michael Eisenberg

Michael L. Eisenberg

With 15% of all couples experiencing fertility issues, and semen deficiencies demonstrated in half of those cases, Eisenberg said the area deserves more attention.

“If a couple is having trouble conceiving, a man should get evaluated because there may health ailments that can be treated,” he said.

Eisenberg and colleagues analyzed medical records of 9,387 men (mean age, 38 years) with semen data available. The men were evaluated at Stanford between 1994 and 2011 to examine causes for their infertility; abnormal semen was the problem in nearly half of all male fertility cases, and 44% had at least one medical diagnosis unrelated to infertility.

Using the Charlson comorbidity index, the researchers stratified the cohort and measured differences in semen parameters. Men with a higher Charlson comorbidity index score demonstrated lower semen concentration, motility, volume, total sperm count and morphology scores.

Overall health status was compared between men with semen defects and those without. Men with endocrine, circulatory, genitourinary and skin diseases all demonstrated higher rates of semen abnormalities.

Further examination into conditions of the circulatory system showed men with hypertensive disease, peripheral vascular and cerebrovascular disease and non-ischemic heart disease had higher rates of semen abnormalities.

Determining what is behind the correlation between semen deficiencies and diseases of the endocrine and cardiovascular systems was not part of the study design, but Eisenberg said most genes connected to reproduction also have functions in other bodily systems. He is currently exploring whether the treatment for disease, rather than disease itself, could be responsible for reproductive malfunction.

“As we learn more about the causes and consequences of infertility, we can better treat patients so that everyone is able to achieve their reproductive goals,” Eisenberg said. — by Allegra Tiver

Did the browser wars finally end in 2014?

The modern browser wars began in earnest in 2004, when Mozilla Firefox challenged Internet Explorer’s complete and utter market dominance, successfully growing from zero to several hundred million users in less than five years.Google took over in 2008, introducing its Chrome browser, which caught up with Firefox by 2012.

The fighting might have finally ended in 2014.

Over the past decade, a lot has changed: Mobile devices now outnumber traditional PCs, and the desktop browser has become much less important than mobile web clients and apps. Apple’s mobile Safari and Google’s Chrome are now major players, Mozilla is in a time of major transition, and Microsoft is still paying for its past sins with Internet Explorer.

And in 2014, all those players seem to have dug in to well-entrenched positions. Here’s an end-of-year status report for each one.

Google Chrome: on a path to world domination

Google, it turns out, would love to have the dominant market share that Internet Explorer did back in its heyday, without the performance and security nightmares associated with IE.

The company is using a move straight out of the Microsoft playbook from the 1990s, using its dominant free services (Google Search, Gmail, and YouTube, in particular) to push the Chrome browser, and adding capabilities that require Chrome apps, which are designed to create the same type of lock-in that Microsoft’s ActiveX enforced in the early days of the Web, minus the horrible security flaws.

Docs, Guns, and Smokes.

Family doc/tobacco researcher spearheads physicians’ role in gun safety research.

  • by Jennifer Ferris
    North Carolina Health News/MedPage Today

CHAPEL HILL, N.C. — One day in clinic, 2 years ago, a patient handed Adam Goldstein, MD, MPH, a request for a concealed weapon permit, soliciting his signature.

The family physician didn’t know what to do. “What do you mean fill this out on a patient? First off, what do I know about guns and safety? And second, what do I know about that patient?” Goldstein didn’t sign that form, nor has he signed any others that have come into his office since.

At the time, Goldstein didn’t know anything about gun safety issues, but he’s no stranger to public health. For nearly 20 years, he’s been the guy showing the world how tobacco use in the media turns kids onto smoking and dipping. This research, conducted in the heart of tobacco country, has changed U.S. policy. And teen smoking rates have dropped by nearly half since he began.

Now, prompted by the patient encounter from 2 years ago, the physician says he has embarked on a new research topic: physicians’ role in gun safety.

This hybrid career of clinical practice and research is the right fit for Goldstein, who says he originally set out to work in public health full time, but then found great personal satisfaction in treating patients. “Seeing patients is the great equalizer in academics. If you don’t see patients you don’t get much respect among your peers. The more you do that, the more respect you have. For me it’s always been a dual track,” he said.

Fueled by the concerns of his colleagues facing questions of gun violence, and tragedies like Sandy Hook Elementary School, Goldstein is beginning to publish the first bits of research on family medicine and firearm safety.

Early Career: Forging a Hybrid Path

As an undergraduate at Tufts, Goldstein focused on the sociology of healthcare. He says he found large-scale public health fascinating. But when it came time to choose a career path, he set his sights solely on Augusta State University Medical School, now part ofGeorgia Regents University, with a career goal of working in a public health department.

In medical school, Goldstein took his first steps toward working in public health with preventive medicine community service projects, and by joining Doctors Ought to Care, a physicians’ organization that connects doctors and patients with media literacy tools. But, Goldstein reflects on his clinical rotation, “I realized that I really loved the individual patient care element. Even more so than the public health movement.”

After graduating in 1987, Goldstein decided on a residency at UNC Family Medicine to pursue a career in both academic research and patient care. “I was probably a bit of a pariah” Goldstein says. “Because I wasn’t taking the same path and I didn’t want to go out to a rural practice.” Most of Goldstein’s peers went into rural care.

“I wanted to be in an academic health center: teaching, researching, doing care,” he says.

Tobacco Research Pioneer

That same year, Goldstein published the first study addressing media influence on teen smoking habits. After that initial success, Goldstein says he was under a lot of pressure by his peers in research to forgo practicing family medicine and focus on his funded tobacco investigations.

Instead, Goldstein chose to let go of committee work and other distractions in favor of continuing with both of his passions: patient care and academic research. Goldstein also makes a little time for his creative outlet — poetry, which is mostly about practicing medicine.

After publishing his initial findings, Goldstein expanded this research, and proved that a group of 3-year old kids were just as likely to identify Joe Camel as Mickey Mouse.

“We showed that the more kids recognize tobacco advertising, the more likely they are to become smokers,” Goldstein says. At the time, he remembers, the causal link between advertising and adolescent smoking was controversial.

By 1999, Goldstein had published 15 tobacco research papers. One such paper, published in JAMA, found that 68% of G-rated films produced by five of the big movie production companies in the U.S. included at least one episode of cigarette smoking or other tobacco use.

Jonathan Polansky is a consultant with the UCSF Center for Tobacco Control Research and Education. He says that Goldstein’s early research was among the factors that pressured movie studios into nearly eliminating smoking from modern G- and PG-rated movies.

“Adam played a very important early role in establishing how much smoking was appearing in the movies,” Polansky says. “Over the ages there were bouts of concern about incidents of smoking in the movies with a common sense belief that seeing it caused children to smoke. We now have research that shows a definitive causal relationship between seeing acts of smoking and teenagers’ future smoking behaviors.”

Since Goldstein’s work began, teen smoking has dropped. According to the CDC, in the early 1990s more than 30% of high school students used tobacco. Today, that number is down to 18%.

Goldstein’s work resonates within academia, with 18 of his papers having been cited at least a dozen times by other researchers.

Goldstein brought his mission to change the culture of smoking to his home state, as well. When he first began his research in the 1980s, tobacco farming and smoking were a cornerstone of life in much of the state. Even today, as the industry is beginning to lag, the North Carolina Department of Revenue reports that the Tarheel state still relies on the “bright leaf” for more than 255,000 jobs and $500 million in revenue.

At his own place of work, UNC, in 1998, Goldstein founded a nicotine dependence program to help employees and patients kick the habit and a wellness program that led to the prohibition of smoking on hospital grounds and outside building entrances.

“No one person does anything on their own,” Goldstein says. “But we have changed how people in North Carolina, in the Southeast, and across the country, look at nicotine addiction and tobacco policy. I know that.”

Docs and Guns

On his public health path, Goldstein says his work in tobacco cessation may never be complete. But in the last few years his attention has shifted to what he sees as a new threat to the wellness of his patients: firearm safety.

After being handed the concealed handgun waiver by his patient, Goldstein says he began to wonder about what a doctor’s role in keeping patients and their families safe from gun violence actually is.

The role of doctors in vetting gun safety is an emerging issue in medical societies and courtrooms.

In April 2014, the American College of Physicianspublished policy recommendations on the topic. A 2014 Florida Court of Appeals ruling upheld a law that limits doctors’ ability to discuss gun safety with patients. The American Academy of Pediatrics called the decision a violation of First Amendment rights and is appealing the ruling.

Goldstein says that doctors must be given the tools they need to help guide patients to gun safety before they are tasked with vetting gun owners for licenses.

“I am not a gun researcher,” he says, “Medical boards need to get involved and we need to start developing criteria to help physicians make these types of assessments that have some kind of validity.”

Finding a lack of published research on the topic, Goldstein has been pursuing the issue. Along with several colleagues, he wrote a Perspective for the New England Journal of Medicine questioning physicians’ roles in assessing competency for weapons ownership.

In a preliminary local survey, doctors in North Carolina said they wanted more information and more policy on this topic. Goldstein says he’s engaged an intern to pursue further research and that he’s working on writing more papers and beginning to travel to conferences to speak on this controversial subject.

Taking Over the Airwaves

Several years ago, Goldstein found an intersection between patient care and public health in hosting a radio show. His show, “Your Health Radio,” is a platform for medical research discussions, which he makes accessible to both medical professionals and the general public with his co-host Cristy Page, MD, MPH.

Together, they take calls from the audience and deliver advice on anything from folk remedies to vaccinations.

One day in September of 2014, Goldstein starts to sweat a little before his first-ever live audience.

Dozens of residents and fellows from UNC medical school, eager to hear him interviewMyron Cohen, MD, director of UNC’s Global Health and Infectious Disease department, squeeze into a conference room crammed with microphones, speakers, and a host of recording equipment — thanks to the show’s host station WCHL.

Goldstein questions Cohen about the Ebola epidemic. Attempting to keep the conversation accessible, with a minimum of technical terms, Goldstein says to his guest, “Let me ask you a quick question here. The early symptoms of Ebola — we’re about to be in flu season and it appears to me the symptoms overlap with flu.”

Cohen quickly took advantage of Goldstein’s prompt, explaining the difference between influenza, stomach flu, and Ebola. Guiding his speaker to the explanation was his way of reaching worried listeners in Idaho, rural North Carolina, and further away, for reassurance.

Goldstein spends a half hour after the radio show answering questions from the white-coats in the audience. Later, he reflects on his career and the harmony he has found among supervising students, helping patients, and furthering the course of global health.

“Every physician wonders about whether they are succeeding,” he says. “Every person wonders about trying to do the best they can. I think each and every day is a challenge. The opportunity is there to do well and to do mistakes. I try to improve the ‘do well’ part, and I try to limit my mistakes.”

Syphilis Test Gets OK for Wider Use

FDA allows use outside traditional laboratory settings.

A fingerstick blood test for syphilis is simple enough that untrained healthcare workers can use it outside of traditional laboratories, the FDA has ruled.

The agency approved the so-called Syphilis Health Check test in 2011 and categorized the assay under its Clinical Laboratory Improvement Amendments (CLIA) rules as moderate- and high-complexity, meaning it could only be performed in a lab qualified at that level.

The FDA said today it would waive that requirement, making it possible for the test to be used in physicians’ offices, emergency rooms, maternity wards, other healthcare facilities, and a range of other sites.

Also, workers using the test won’t require specific training, the agency said. The CLIA waiver is the first for a syphilis test.

“The broader availability and easier access to this test should contribute to a higher rate of detection of syphilis infection,” Alberto Gutierrez, PhD, of the FDA’s Center for Devices and Radiological Health said in a statement.

The agency made the move after the manufacturer, VEDA LAB of Alencon, France, submitted data for whole blood samples from 417 subjects collected by fingerstick over the course of 4 months at three testing sites representing typical CLIA-waived sites, such as doctors’ offices.

Twelve people not specifically trained in the use of the test performed it on patients, and results showed that in their hands the test performed with high accuracy, the FDA said.

While syphilis is easy to treat, the number of people in the U.S. who have the disease has been rising, reaching 16,663 reported cases in 2013 according to the CDC. The annual rate for that year was 5.3 primary and secondary cases per 100,000 population — nearly double what it had been 8 years earlier in 2005.

But that number is almost certainly an underestimate, since it is based on 34 states and the District of Columbia. The true number, the CDC thinks, is closer to 55,000 new cases a year.

The increase is almost entirely among men and most of that — about 75% — is among men who have sex with men. Some experts suggest that the blame can be laid at the door of a culture of quick anonymous sex, facilitated by Internet sites that allow easy access to a multitude of partners.

The infection, by the bacterium Treponema pallidum, can cause long-term complications or increase the likelihood of HIV transmission if not treated, the FDA statement noted, and can also infect a fetus if the mother has the disease, causing infant death, developmental delays, and seizures.

The test uses whole blood from a fingerstick and results can be available within minutes, the agency noted. The speed of the test allows healthcare workers to get a second sample at the same office visit to confirm any positive results and that, in turn, increases the probability of timely treatment, the agency said.

The treatment for primary, secondary, and early latent syphilis is a single intramuscular injection of long-acting Benzathine penicillin G, and three shots will cure later stages.

Currently, the CDC recommends syphilis screening at least once a year for all sexually active homosexual, bisexual, and other men who have sex with men. As well, the agency urges that all pregnant women be tested for syphilis at the first prenatal visit, while those who are at high risk, live in areas with high rates of syphilis, or were previously not tested should be tested in the third trimester and again at delivery.

More Women Are Getting Their Tubes Tied; Permanent Birth Control Second Most Popular Option In US.

Female Sterilization Becomes More Popular

Surgery is becoming a more popular contraceptive option. 

The birth control pill has been the most popular, long-standing contraceptive choice among women, but a more permanent route is close behind. A nationwide survey conducted by the Centers for Disease Control and Prevention (CDC) found the unexpected contraceptive approach of female sterilization is almost as frequently used as birth control pills.

Opting for surgery seems extreme “until you start to peel back the layers and intricacies around forming a family,” Dr. Vanessa Cullins, vice president of external medical affairs at Planned Parenthood Federation of America, who was not involved in the study, told Time.“Consider the fact that the majority of women in this country have had the number of children they want to have by [their] mid-20s to 30, or so — and they still have the capacity to get pregnant until they are 50 years old.”

The dangers of becoming pregnant continue to increase significantly after the age of 30, when many women have already given birth to the amount of kids they want. There are roughly 20 years between that time and when she physically can’t anymore because of menopause. According to Cullins, the majority of women who ask about sterilization don’t want to deal with other contraceptive methods, especially those that require maintenance.

Nearly 62 percent of women in the U.S. between the ages of 15 and 44 use some form of contraceptive. The survey found that between 2011 and 2013, 16 percent of women were using birth control pills while 15.5 percent were choosing female fertilization. Male condoms came in third place with 9.4 percent of couples using them during sex, and long-acting reversible contraceptives such as intrauterine devices (IUD) came in last at 7.2 percent. Experts are expecting IUDs to become more popular as the industry makes them more affordable, although younger sexually active women between the ages of 15 and 24 were less likely to use them.

Female fertilization appeals more to middle-aged women because of its reassuring statistics. Less than one out of every 100 women who are sterilized become pregnant, meaning it provides a lifetime of reliability. It’s commonly known as a woman getting her “tubes tied” because her fallopian tubes are literally cut or blocked. The tubes lead to the woman’s ovaries, and into the uterus or womb. If the sperm can’t cross the tubes, it’s not possible for them to fertilize the egg and conceive a pregnancy.

Source: Daniels K, Daugherty J, Jones J. Current Contraceptive Status Among Women Aged 15–44: United States, 2011–2013. NCHS Data Briefs. 2014.



Most of us have seen the Top 10 lists of why we should be drinking lemon water.  But do we really know the added vitality and cleansing effects on the body lemon water provides?

Lemon water sounds like a good idea, and you’ve probably seen pictures on Pinterest of large pitchers of water with vibrant lemons and the top 10 reasons why you should be drinking it.

It’s easy to take these images and lists at face value, and most won’t end up actually drinking lemon water regularly, rather be able tell their friends the top 10 reasons lemon water is good for you.

We’re interested in the part that adds vitality and incredible cleansing effects on the body. If you’re just getting started on a path of feeling better through diet change then making a replacement of lemon water for a morning coffee is a great first step. I truly believe that we have the power to heal our bodies by adapting what we consume every day. Our challenge is to:

  1. Look through the top benefits we’ve listed below and find the one benefit that will motivate you to start incorporating lemon water into your daily life.
  2. Commit to 14 days of lemon water
  3. Write down how you feel on day 1, then on day 14
  4. Let us know what you experienced.

What We Know About Lemons

Botanically, it is a citrus fruit in the Rutaceae family (scientifically known as Citrus Limon), and while being the smallest in its family has more comprehensive health benefits than its family members (1).

They are likely to have originated in India around the Himalayan foothills and spread from there.  The two main types of lemons are the Lisbon and Eureka.  There are other’s that have come into vogue such as the sweeter Meyer Lemons.

The fruit is lower in calories about 29 per 100 grams, which makes it one of the lower in its family.

Lemons as a Source of Vitamin-C

We know lemons are high in vitamin C which is essential for normal growth and development (2).  A single lemon contains around 30-40 mg of vitamin C (3) (in comparison an orange contains around 80-90 mg of vitamin C).

Vitamin C has been studied extensively and shown to have a myriad of health benefits from protecting against prenatal problems, cardiovascular disease, eye diseases, skin wrinkles, and immune system deficiencies (4).

It acts as an antioxidant and helps protect cells from damage caused by free radicals (5).

If you’d like to go down the rabbit hole of vitamin c start with this fact sheet, as we’ll be focusing on some of the more unique properties of lemon water.

Unique Health Benefits of Lemons

1. Lemon Water as Detox and Cleanse

This is the first benefit that comes to mind when it comes to lemon water, and usually the most overstated.  We’ve cited a few scientific sources that give true insight on the potential for lemon water as a natural detox.

Not surprisingly, the amount of urine is increased when drinking lemon water however lemon water brings with it the primary compound known as Citrate.

This is a naturally-occurring inhibitor of toxins (which can build up in the form of crystals in the body).  The Citric acid enhances your body’s ability to naturally flush out these unwanted toxins.

Toxins come into our systems through various sources from the air we breathe to some of the foods we eat. Two of the more well known studies shed some light on the use of lemon as a cleanse:

  • As published by Dutch researchers in a 2002 edition of the European Journal of Nutrition, lemon peels and the waste stream of the lemon peels are effective in lowering blood and liver cholesterol levels. Although performed on animal subjects, these results insinuate that lemon peel consumption could be beneficial to those with fatty liver disease.
  • As published by Indian researchers in a 2005 edition of BMC Pharmacology, hesperidin (a citrus bioflavonoid found in lemons) demonstrates the ability to protect the liver from damage. After administration of CCl4 (a well known liver toxin), the authors concluded that hesperidin demonstrates a protective effect on the liver (6).

Our liver is where we filter everything we consume and neutralize many toxins.  We’ve covered the various methods of cleansing with related products like apple cider vinegar.

These studies shed light on the lemon’s ability to enhance the liver’s function of filtering out unwanted toxins.

The main premise behind lemon water as a detox revolves around its ability to enhance your bodies enzyme function and stimulate the liver.

Studies indicate that in cases where toxins have built up in the body, the lemon juice and peel have cleansing properties. Using lemon water, especially after meals may help you lower the amount of toxins in your body.

2. Improve Digestion with Lemon Water

Citrus flavonoids are the primary cause of improved digestion when drinking warm lemon water.  They aid in the assimilation of food, help prevent fatty liver, decrease chances of cardiovascular disease, fat-lowering, and reduced insulin sensitivity.  This has to do with it’s ability to inhibit certain synthesis of fat in the body (7).

Citrus flavonoids act as a great digestive tonic, with appetite suppressing abilities (8).  It has also been shown to calm an upset stomach or mild indigestion.  This has to do with the hydrochloric acid in your stomach that start the process of breaking down your food.  It is believed the citrus flavonoids in lemon water support the hydrochloric acid in the stomach in breaking down food (9).

The best way to utilize lemon water as a digestion aid is to also include the zest of the lemon which will improve the good bacteria in your gut.

3. Alkalize with Lemon Water

If you’re new to the concept of alkalinity, it’s the process of neutralizing acid in the body.  The basic idea is your body has certain acids that can build up causing negative side effects such as acid reflux, upset stomach, acidosis, and  beyond (10).

There are various ways to check the pH levels of your body to find out if you are too acidic.

An ideal range to fall between is 4.6-8.0 and can be tested with pH strips using saliva or urine (11).

If you plan to use lemon water or alkaline drinking water to manage your body’s acid levels we recommend speaking with your doctor first and identifying your pH levels.

If you identify a need to alkalize, then we recommend getting some home pH strips that will allow you to stay within the recommend ranges.

Lemon water is a safe and effective way to manage your pH levels and achieving healthy alkalinity may benefit in bone health, reduced muscle wasting, decrease chances of hypertension and strokes, improved cardiovascular health, and improved memory (12).

4. Weight loss/Appetite Suppressant

We’re approaching this claim with caution since any new health fad that becomes popular can get turned into a “fat burning miracle”.

There is a lack of scientific research that supports the claim of weight loss fully, however this doesn’t mean the claims are false, simply that additional research is needed (13).

One of the studies that does exist was not a human trial but did show significantly reduced weight gain when a diet high in fat was being consumed (14).  Most people whether they want to admit it or not fall in the high fat diet category.

Pectin and polyphenols are the main substances found in lemons that have more research available showing weight loss and appetite suppressing qualities.

Pectin gives a feeling a fullness much like other soluble dietary fibers, that may help reduced caloric intake.

In one study these two substance increased fat metabolism, increased HDL (good) cholesterol & lowered LDL (bad) cholesterol and decreased the production of inflammation (15).

The main study was carried out by Drs. Sheau C. Chai, Shirin Hooshmand, Raz L. Saadat, and Bahram Arjmandi, of Florida State University.

“It’s a Slow Process Don’t Make it Slower by Quitting.”

Every “body” will respond differently to lemon water, which is why we recommend adding this to your diet without any other major changes to isolate the effects.

This will allow you to better attribute any changes you experience and not be confused if it was the new multivitamin you started taking.

While additional research is needed regarding the weight loss benefits of lemon water, positive benefits are achieved by replacing sugary drinks for lemon water.

We recommend replacing your morning coffee with lemon water for at least 2 weeks.  Keep a journal of your mood, energy, and cravings for the 2 weeks to see what positive benefits you experience.

5. Reduced Wrinkles and Improved Skin

This claim states benefits from both drinking lemon water and applying topically.  Lemons have been found to be high in antioxidants (16) which are linked to anti-aging properties.

The primary cause of aging comes from free radicals that cause the breakdown of various tissues in the body, namely skin.

Research showed that plant derived antioxidants were able to reverse the breakdown of collagen fibers in the skin (17).

Collagen gives skin it’s strength, structure, and plumpness while protecting the skin from absorbing toxins (18).

Now the next time you see your friend with great skin you can tell her you’re jealous of her collagen.

Free radicals in small amounts are not damaging to the body, but you should be aware of practices that increase your exposure to free radicals.

The most common and most dangerous forms of exposure can come from drugs, radiation, pesticides, air pollutants, solvents, alcohol, tobacco smoke, pollution, and even foods we eat (19).

Most healthy people who do not smoke should not be overly concerned with too much free radicals in their system.

If you are concerned or curious you can take a urine test to get an idea of where you’re at (20).

If you want to apply lemon juice topically there are various ways depending on preference.  The simplest way is to dilute in water and pat on the face with a damp cloth avoiding the eyes.

Other methods range from creating sugar scrubs to combining with Greek yogurt.  In all cases the antioxidants in the lemon will be the active ingredient.

6. Benefits of Essential Oils in Lemons


Essential oils as a whole is a topic we will cover in greater detail since there is a lot of debate on their effectiveness, especially when you look at the claims.

There are however plenty of benefits that come from essential oil use, but we’ll stick to those that have been researched and tested.

At the time of this writing we found 14000+ articles that had essential oils being studied and researched (25), and lemon oil had over 500 alone.

If you’re looking to get the oils into your lemon water simply take the peel and squeeze or twist the outer zest portion.

If you watch closely you’ll be able to see the lemon oils coming out of the zest.

One of the most interesting benefits that has been linked to lemon oil is its moderate antimicrobial activities against bad bacteria, yeast and fungi such as Candida albicans more commonly known to cause yeast infection (26).

These antimicrobial effects have a range of benefits when ingested and used topically, and are the core of where the benefits are derived.

A study was published took a look at how lemon oil would affect pregnant women dealing with vomiting and nausea.  Around 100 women participated and after just 2 days reports of dramatically decreased symptoms were reported as compared to the placebo group.

After 4 days a decrease of nausea and vomiting was seen on average of 33% (27).

While this study was specific to pregnant women, it may suggest that those dealing with similar issues who are not pregnant would see similar benefits.

In another study performed by the Central Food Technological Research Institute looked at how geraniol, a phytonutriant found in lemon, aided in reversing diabetic neuropathy.

The study showed that sciatic nerve damage was reduced through lemon oil (geraniol) use.  In the full 8 week study cellular function was restored, suggesting that the use of lemon oil regularly can assist in regulating energy stores, and as previously mentioned help preventing disease (28).

Lemon oil is perhaps the most researched part of the lemon and also the part no one seems to include when making their lemon water.

Consider using the zest of the lemon in your drink or extracting the oils to include in your drink for maximum benefit.

Lemon Water Safety Measures

Safety measures for lemon water?!?  I know what you’re thinking but there are a few things to keep in mind:

First off you really shouldn’t be eating the seeds of the lemon.  A few here and there aren’t going to be terrible for you, but if you plan to drink lemon water regularly then make sure you’re avoiding the seeds.

They contain small amounts of salicylic acid which is the main ingredient in asprin, along with the bitter/astringent coating on the outside of the seed which gives it the bitter taste.

The easiest way I’ve found to get rid of them is to use a small strainer or a lemon press.

If you’re used to sweetening your tea or coffee then your taste buds are going to want a spike of sugar in your lemon water.

Try and avoid adding sweeteners other than raw honey as it will negate many of the benefits I mentioned.

If you can start to cut more and more sugar out of your diet, you will find your taste buds resetting and your cravings for sugar drop dramatically.

I had never experienced this until I cut out most of the sugars in my diet, but I can honestly say my cravings for sugary foods dropped dramatically.

Another common concern is what effects lemon juice has the enamel of your teeth.  As long as you’re not using it like mouthwash your teeth will be safe.

With the amount of soda that people drink in our time, substituting lemon water will actually save your teeth.  If you’re super concerned about it then try using a straw

Drinking lemon water is one of these little things that we can do on a regular basis that can have long term benefits.

The people who will the most dramatic effects in the beginning will be those who can replace a morning coffee or soda with lemon water.

As with any new addition to your diet, I recommend giving it a minimum of 2 weeks to see what positive benefits you’re getting.

We’re so used to instant gratification in almost everything we do, so when it comes to healthy diet and exercise it can be easy to get discouraged if we don’t see results in a few days.

E-Cigarettes: Teens Are Major Market.

Time to limit sales to 18 and older?

The danger e-cigarettes pose to teenagers appears to be increasing the longer e-cigarettes go unregulated. A study in the January issue of Pediatrics found 29% of teenagers surveyed have tried e-cigarettes – with 62% of those reporting using them in the last month, and 44% of those using them three or more times in the last month. Researchers also found that 67% of respondents considered e-cigarettes to be “healthier” than regular cigarettes.

Lead author Thomas A. Wills, PhD, professor at the University of Hawaii Cancer Center in Manoa, pointed out that teenagers may not realize e-cigarettes contain nicotine, which is an addictive substance. “One Surgeon General’s report in fact documented that, in several aspects, nicotine is more addictive than heroin,” Wills said.

A recent study in the New England Journal of Medicine has called for FDA regulation on the $2.2 billion e-cigarette industry, and the AMA hasrecommended similar regulations, including an age restriction of 18 for purchasing e-cigarettes.

As e-cigarette use among the total population has doubled every year since 2009, teenagers have mirrored those trends. The National Youth Tobacco Survey reports e-cigarette ever-use among teenagers was up significantly from 4.7% in 2011 to 10.1% in 2012.

There are two possible hypotheses behind the appeal of e-cigarettes to teenagers, according to the study. In one model, e-cigarettes act as a less dangerous alternative to cigarettes and were preferred by teenagers with “conservative and health oriented values.” In another model, teenagers see e-cigarettes as similar to alcohol and marijuana: a way to “rebel against conventional values.”

However, the data was unable to confirm either explanation. Although both notions are plausible, there is little empirical evidence to support or reject either theory at this time, the authors wrote.

Researchers surveyed 1,941 students in three public and two private high schools in Oahu. The mean age of respondents was 14.6 (SD = 0.7), with a 47% to 53% male-to-female demographic breakdown. Parental consent and adolescent ascent were both required to participate in a 40-minute survey, and the response rate was 76%.

To determine the prevalence of e-cigarette use compared with cigarettes, alcohol, and marijuana, respondents were asked to determine frequency of use on a scale of 0-6 (0 being “Never” and 6 being “Daily”). E-cigarette ever-use (1-2 times or more) was nearly double that of actual cigarettes (15%) and marijuana (18%), though it ranked second behind alcohol (47%).

The study then examined psychosocial variables divided into categories thought to predict risk-seeking behavior: Social-cognitive risk factors, social-cognitive protective factors, and problem-behavior risk factors. When e-cigarette users were contrasted with users of both e-cigarettes and regular cigarettes, researchers reported dual users had a higher positive correlation (P>0.001) with social and behavioral risk factors.

Respondents who only used e-cigarettes did not score high on variables such as rebelliousness, sensation seeking, and peer smoker affiliations when compared with dual users, the authors wrote. But because they scored higher on these risk factors than their nonsmoking counterparts, the study determined e-cigarette users likely fall into an “intermediate risk group.”

But when the study crossed e-cigarette users who also frequently used cigarettes, alcohol, or marijuana, there was a correlation (P>0.001) with 14 out of 15 psychosocial variables. Statements such as “I like to break the rules,” “Smoking helps you feel more [self-confident]” and “Do any of your friends smoke cigarettes” exhibited the greatest correlation with e-cigarette users who frequently used other substances.

“Our findings suggest that e-cigarettes may be operating to recruit lower-risk adolescents to smoking,” said Wills. He also points out that both cigarette and e-cigarette use has increased among teenagers, which is difficult to reconcile with the contention that tobacco is being put out of business [by e-cigarettes], he said.

The most important limitation of the study may be its location. Hawaii has particularly aggressive advertising for e-cigarettes, and the authors pointed out that may lead to parents seeing e-cigarettes as a more desirable alternative and buying them for adolescents. Other limitations include lack of information about how long teenagers have been using e-cigarettes and that the survey only collected data in one sitting.

“It would be desirable to follow a group of adolescents … and obtain several assessments about e-cigarette use and cigarette use in order to determine how one type of use affects other types of use over time,” Wills said.

Lyme Disease, Fibromylagia Link Evaporates.

Earlier studies may have included patients who did not have Lyme disease.

Lyme disease is not a trigger for fibromyalgia, according to a long-term assessment of patients with culture-confirmed Lyme disease.

The prevalence of fibromyalgia among patients with culture-confirmed Lyme disease who were followed at the Lyme Disease Diagnostic Center in Westchester County, N.Y., for up to 20 years was no greater than that in the general population, say investigators at New York Medical College in Valhalla, N.Y., led by Gary P. Wormser, MD.

Earlier studies that suggested that Lyme disease may trigger fibromyalgia were performed before the use of two-tier serologic testing for Lyme disease and therefore may have included patients who did not actually have Lyme disease, the investigators wrote online in Arthritis & Rheumatology. Further, these studies did not follow Lyme disease patients over the long term.

In the current study, 100 patients with a diagnosis of Lyme disease confirmed by recovery of Borrelia burgdorferi from culture — the gold standard for microbiologic confirmation — were systematically evaluated for fibromyalgia using both prior and current diagnostic criteria 11 to 20 years after the onset of Lyme disease. At diagnosis, patients were treated with antibiotic regimens consistent with current guidelines.

During 2011 to 2013, patients were evaluated by interview and tender point examination at 18 specific sites to determine if they met the criteria for a diagnosis of fibromyalgia using both the 1990 criteria (including the use of tender point examination) and the 2011 criteria (omission of tender point examination). At least 11 tender points or a total symptom score of 12 or greater was required to diagnose fibromyalgia, lacking an alternate diagnosis to explain symptoms. All 100 patients were interviewed, and 87 had a tender point examination.

The 100 patients had a mean age of 64.9 years at the time of their assessment for fibromyalgia, and 52% were male. The mean duration of follow-up since culture confirmed their Lyme disease diagnosis was 15.4 years (range 11 to 20 years). At least twenty-four of the 100 patients had an additional episode of early Lyme disease (i.e., erythema migrans) during follow-up. Sixteen of the 24 had one additional episode of erythema migrans and eight had two subsequent episodes.

Only one patient met the interview criteria for a diagnosis of fibromyalgia. Only one of the 87 patients who underwent tender point examination had at least 11 tender points. The prevalence is consistent with that in the general population, the authors note.

“Furthermore, at least 24% of our patients experienced a second episode of early Lyme disease associated with erythema migrans during the follow-up period suggesting that repeated episodes of early Lyme disease also infrequently trigger the development of fibromyalgia,” according to the authors.

One limitation of the study “is that we cannot exclude that fibromyalgia is triggered, lasts for a period of time and then resolves in some patients beginning at or shortly after the diagnosis of Lyme disease when the patients are most likely to be symptomatic,” they wrote. Another potential limitation is selection bias — 200 patients were enrolled but only 100 returned for follow-up assessment of fibromyalgia.




Whether you have come face to face with it already or else haven’t recognised it yet, it doesn’t matter. What matters is that you have a purpose in life and at some level you know it for certain. Trust me you do.

Are You Aligned with your Life Purpose?


I see people who are driven by that unshakeable knowledge of their path, their place in the world and their destination. They have found their purpose. Their eyes are set on that path and its not the outcome – the money, the success, the recognition or whatever it may be – that is their motivation but it’s the excitement of being on the path itself. It’s that compelling future grounded in the rock solid alignment with their purpose in the present. Whatever they do flows effortlessly and with ease. Success and self-realisation are only an unavoidable consequence.

I see many others who plod along their life, fire fighting adversities and struggling to keep pace with an unstoppable stream of events and situations, most of which they feel are difficult or pushing them away from a point in life they would rather be. They feel they are walking uphill or swimming against current. Life feels a constant bombardment of things they have no control over and it is running them past too fast. Their purpose is yet unclear as they wander aimlessly through many disconnected way points. I have seen this very clearly through my own life experience.

Popping the Question


Knowing your purpose in life has become the holy grail in personal development literature over the years and for good reason. It is the biggest turning point in anyone’s journey. It’s the one key that opens up many doors and not just in your practical day to day living but in all other aspects of life – relationships, spiritual, emotional and overall wellbeing. Most people ask these questions at least once in their life – “What is my life purpose?” , “What have I come here to do?”, “Does my life have a deeper meaning, a single purpose or a path I need to follow?”. For some it can be a question that takes them on a pursuit to the far reaches of the globe – trying to find the answer in sacred places or in the words of mystics, gurus and sages. The rest simply face it on and off at several points of intersection in their life and at different degrees of acuity.

The Secret to Finding your Life Purpose


A more pressing question for most people is “How do I find my purpose in life?”. The question has the inherent assumption that there is a method, technique or something one needs to do or consult to get an answer. And if there isn’t a method, then how is it that some people know their purpose while others do not? What is the key ingredient?

What I am about to tell you may sound counterintuitive but the secret is not a key ingredient but actually a missing one!

In short you do not need to add something to understand your life purpose but you need to shed off some inessential stuff away – you need to simplify. The truth is very simple :) You do not know your life purpose not because you do not have one or you need a special ability or insight to know it but because it is hidden away under layers of stuff which do not belong to you and have accumulated over the years. Let me explain.

Peeling the Onion Layers

As social creatures we are all to some extent living out ready made templates laid down to us by society. They are not ours. They are not genuine or authentic. What do I mean by ready-made templates? Simplistically speaking a template might look like – do the cool or mindless stuff teenagers typically do, then get in a steady relationship in your 20s, graduate from college, find a steady job, buy a house, get married, have kids, buy a bigger house, be the envy of the neighbourhood, achieve recognition or status of some sort and so on. These are pre-installed programs of what we should do or achieve. There are many of them for us to pick and activate.

These programs are mainly run by peer groups, institutions and the media, propagating and reinforcing them in us as we grow older. Through the years, we accumulate more code through which the program can work and grow. Quite purposefully, in my online course The Art of Simplicity I explain two important key points in separate lectures. One is about how society has blurred the distinction between needs and wants and have sold us wants as needs. The other powerful point is identifying those mental barriers to a simpler, more authentic life and how to practice overcoming them. These mental barriers make up the core framework upon which the social templates are built.

The point about needs and wants is an important one. In the modern day society we actually have a small number of needs but a massive list of wants. The hyper-consumeristic culture has led us to believe, under a heavy spell of mass media, that our wants are actually needs. You need this or that to look hip, be awesome, be approved and looked upon by your peers. We were gradually lured in a fabricated social reality and made to believe it is our own.

Pay attention: This has created the confusion over your true purpose in life.

You may feel good for a while when you live out the social templates and tick off the boxes of the goals setup for you by society: I got married – tick. I got a job and am paying off my mortgage – tick. I settled financially and have a better than average income amongst my friends – tick. I am living with the trends and accepted by my peers – tick. What we don’t realise is that these are not our goals or milestones but ones which were modelled by others for us to follow in order to feel accepted. Throughout life, people keep on picking up more and more of these models to follow. They start building up the metaphorical layers of the onion. Yet the thing is that no matter how many of those tick boxes are ticked off, it says nothing about your true purpose or rather the more tick boxes you have to tick the more your true life purpose is buried under the onion layers.

So back to the key point. Those people who know their life purpose and follow it faithfully have nothing more or better than you. They just can’t care less of those tick boxes and have peeled off the onion layers to get to the core of their truest life aspirations. They have simplified their life and shed off all the inessential items – mainly those templates society has made us believe that we need or must follow. In other words simplicity is the real key to finding and living out your authentic life purpose. It’s such a simple truth that I feel almost flabbergasted at the idea that I haven’t seen this clearly earlier in my life. It’s such a simple truth that I am now compelled to convey this knowledge to others – through my writing and an online course I have created purposefully for this.

I have created online lectures in a course titled The art of Simplicity. Through this course, I am committed to teach people how to simplify all aspects of their lives and shed off those inessential things we have accumulated through time. They are straightforward lessons on how to peel off the onion layers of our lives which are keeping us from seeing more clearly who we are and what is our true life purpose. The course gives practical tips on how to simplify our day to day living at home, work, business, relationships and parenting. It gets down to step-by-step instructions on for example how to declutter our living spaces, manage time and information, how to simplify and make our relationships more meaningful and how to make parenting simpler and more effective.

More importantly however it gives a powerful insight into those mental blockers that are holding us back from seeing and following our life purpose and practices to overcome them. If I had to ask you “are you free to do and follow the things you are passionate about?”, “are you in a point in life where everything flows easily because you are doing that one thing you know you should be doing?”, “are you in a point in life in which whatever practical obstacles come your way are either irrelevant or overcome easily?”. If the answer is yes to all those questions, then my friend you are blessed with knowing and living your life purpose. There is no other explanation for it. If the answer is no then I have some very good news for you – It is there waiting for you to be found by simplifying your life and returning to your true bare life essentials.

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