In This Issue
5 Ways to Lose the Bloat
My Salad Has How Many Calories?
7 Workout Myths Revealed
Best Foods to Eat When You Have Your Period
Twins Separated at Conception

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5 Ways to Lose the Bloatbloat

Are you waking up feeling a little puffy? Do you need pliers to pull your rings off and an extra strength shoe horn to squeeze your feet into your ballet flats?

Besides your waistline, you may notice a little bloat in your face, neck, fingers and ankles. You are retaining a layer of water just underneath your skin. Don't freak out. It happens to everyone. It isn't fat and you don't have to get used to it. You can banish it with a little know-how.

1) Fluid pushes fluid. If you are retaining water, you may be dealing with a little electrolyte imbalance. It may feel counter-intuitive, but drinking water will flush (literally) the extra fluid from your system. Steer clear of the bubbly stuff and if you're looking for a little extra zip to your H2O, toss in a slice of lemon, grapefruit or cucumber, which may help you suck down a little more.

2) Ditch the dairy. Dairy isn't easy for most adults to digest. As we age, we lose the enzyme needed to break down and process milk sugars - the side effect is bloating, gas and cramping. Take a few days to forgo milk and dairy products completely. Don't substitute them; just take a break from milk, cheese and yogurt. If you notice a big difference, you may be intolerant, so try adding back dairy foods one at a time. Try yogurt first and no other dairy and see if the bloat returned. The next day try milk in your coffee. Add one dairy food a day with the ones you tolerate so you can see what works for you.

3) Reach for tummy-friendly fruit. So, believe it or not, you are better off not going for the apples, pears and melon if you want to pull off the water weight. Choose berries, lemons, oranges, grapefruit and grapes, as they don't hold on to water and are more easily digested.

4) Don't eat things you can't pronounce. Eliminate all artificial sweeteners and diet foods. They can make you bloated and trigger gas and diarrhea: exactly what you don't want. Stay away from xylitol, maltitol, sorbitol and all the artificial sweeteners. You don't need the diet yogurt, soda, cookies or other nutrient-poor foods.

5) Cut the starch. Starches -- especially the processed ones, like cereals, pastas, breads and crackers - cause the body to hold on to water. You don't want that. Either do without the toast, or choose whole grain versions like rice, root vegetables or oats. They're better choices, anyway.

My Salad Has How Many Calories?salad2
Sometimes a "light lunch" can contain more than 1,000 calories! Read on and pile your plate high without widening your waistline with these slimming swaps.

Swap Croutons for Crackers
Red light: whole-wheat croutons (80 calories for 8). Whole-wheat equals healthy, right? Not when it's been brushed with butter before being toasted.
Green light: crumble two saltines over your salad for 25-calorie crunch. Other on-the-lighter-side toppings with satisfying snap: water chestnuts and jicama.

Change Up Your Chicken
Red light: crispy chicken (380 calories for 4.5 oz). "Crispy" is code for "fried." Also, beware the term "panko-crusted"; it's just a fancy way of saying the chicken has been breaded.
Green light: with all the hunger-sating protein but about 250 fewer calories, a grilled chicken breast is a much better bet.    
Choose Cheese Wisely
Red light: blue cheese (100 calories per oz). Stilton, roquefort, and gorgonzola are good sources of calcium and protein, but they're also high in calories-not to mention saturated fat.
Green light: feta contains 25 fewer calories and 2 fewer grams of fat, while goat cheese bumps your calorie savings to 50.   
Go Nuts
Yellow light: walnuts (185 calories for 14). It's true that the 18 grams of fat in these is the heart-healthy kind, but you have to take calories into account too.
Green light: this is one add-on that's not off-limits. Just sprinkle in moderation-and make sure they're the only nut or seed in your salad. 
Can the Cranberries
Red light: dried cranberries (92 calories for 1/4 cup). Berries are loaded with fiber, but the dried version has seven times more calories than the same amount of fresh fruit.
Green light: for a hint of sweetness, choose mandarin oranges, strawberries, or grapes to trim about 60 calories. 
For more calorie-cutting ideas, visit Shape

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May 2016  

May Marks National Women's Health Week

This month marks "National Women's Health Week" (May 8-14th), so we're dedicating this issue with articles that will help you take control of your health so you can look -- and feel -- your absolute best this summer, and beyond.

Here at Lawrence OB/GYN, we play a significant role in women's health. We know that many of you serve as caregivers for your families, putting the needs of your spouse, partner, children, and parents before your own. As a result, health and well-being often becomes secondary. We feel we have a responsibility to support all of our patients and do everything we can to help women take the necessary steps for longer, healthier, and happier lives. Take the time to schedule that check-up, Pap test, or mammogram, and encourage a family member or friend to do the same.

With the summer season about begin on Memorial Day Weekend, it's a wonderful time of year to help you put the "spring" back in your step.  It's never too early or late to work toward being your healthiest you!
Feel like you need to shed those extra winter pounds, and fast?  If you're looking to shape up, but aren't sure if you should start with weights, cardio, or both, we can help you sort through all the misinformation about exercise with 7 Workout Myths Revealed to get you healthy and toned for the warmer months ahead.

If the phrase "bathing suit season" conjures up panic about how to get rid of some unwanted belly bloat, you're not alone.  You might experience belly bloating for many reasons, but it may just be due to your diet.  We offer some great strategies in 5 Ways to Lose Belly Bloat. By making some simple lifestyle changes, you can proudly show off your flat tummy instead of covering it up.
Has this ever happened to you: you're ready to go to the shore or the pool for Memorial Day weekend, and your period has arrived?  Right on time for the festivities!  Hormonal imbalances associated with a woman's period can cause numerous bothersome symptoms. However, eating a nutrient-rich diet for roughly two weeks before menstruation might help prevent or reduce symptoms, such as abdominal cramping, bloating and mood swings.  Learn more by reading, The Best Foods to Eat When you have your Period.

Veggies, salads, and produce, oh, my! The warmer weather is here, so now is the time to start hitting up the local farmer's market and sample all of those yummy fresh foods you've been skimping on these past few months. Get out of the processed food aisles and start focusing on going green. But before you go reaching for those salad tongs, know what to put on your salad so you don't add to your waistline.  Be sure to read, My Salad Has How Many Calories? so you can save hundreds of calories with these slimming salad swaps.  

In this month's issue, Dr. Art Castelbaum of RMA provides important information about today's sophisticated freezing technology regarding fresh versus frozen embryos in his article: Twins Separated at Conception.

Lastly, we'd like to wish all of the wonderful Moms out there a very Happy Mother's Day!

With warm regards,
The Practitioners and Staff of Lawrence OB/GYN 
7 Workout Myths Revealedworkoutmyths
Think you know the facts about getting fit? You may be surprised to learn how many are really fiction. To help put you and your family on the path to a healthier, safer, and more enjoyable workout, here is the lowdown on what's true and what's not when it comes to exercise tips.

1. Weights will make me bulk up.
Unless you are on steroids and throwing around some serious iron, you will not bulk up. In fact, weight training is the only sure way to change body composition. So drop the three pound dumbbells and grab the eight's or 10's. Still not motivated? Know that lifting heavier weights is more effective in increasing muscle strength, which in turn increases your metabolism, and burns more fat. Win-win.

2. Stretching before exercise prevents injury.
It actually can do the opposite. Static stretching (stretches you hold) pre-workout is comparable to taking your car out for a drag race first thing on a winter morning. Crazy. Like your car, you must be warm before you start holding stretches. Cold muscles limit joint mobility and can lead to pulled muscles. A better option is engaging in some dynamic stretches that mimic your planned workout. Think walking before a run. Jumping jacks and body weight squats before lifting weights. Save bending over and touching your toes for the end of your sweat session when you and your muscles are nice and warm.

3. Spot reducing works.
Muscles aren't as single-minded as your fitness goals. Muscles work together. Fat loss and muscle gain is distributed throughout the body, not one area of the body.

4. Running on a treadmill is better for my knees.
The difference in impact on concrete versus a rubberized treadmill, grass or a track is actually relatively small when it comes to joint impact. So if you are worried about your knees, whether you run indoors or out, do a legitimate warmup, like a few minutes of walking combined with dynamic stretches for large leg muscles connected to the knee....think walking lunges, jogging in place or high knees.

5. Crunches are key to a flat stomach.
Or a neck injury. Not only do many people do crunches incorrectly, it is usually the only thing they are doing when it comes to sculpting their midsection. Crunching only works your core in along one plane of motion- (sagittal) front to back. Not cool since there are two other planes dying to join the party- the frontal plane (side to side movement) and transverse plane (rotational). So change things up and add some standing oblique crunches or twists to your lunges.

6. No Pain No Gain.
True, if it doesn't challenge you it won't change you...but if it hurts you then something isn't right. How can you decipher soreness from pain? If you feel the same level of soreness more than 48 hours after a tough workout (it should taper off), then this may be a sign of a pulled muscle or other injury. Also if you feel pain in your muscles or joints during exercise that too may be worth a doctor's investigation. But let's not get it twisted. Feeling the burn should not be confused with muscle/joint discomfort. The burn is where you want to be as this is exactly where your results live.

7. Exercising on an empty stomach will burn more fat.
There is no true evidence supporting this notion so fuel up before you cut up at the gym. Not only will you move slower, doing so can also lead to muscle loss as the body pulls energy from protein when carbohydrates aren't present. So keep it light with a snack that has about 30g of carbs. If you can't stomach food before a workout then sprint to the dining room table no more than 30 minutes after your workout to refuel ASAP.

Best Foods to Eat When You Have Your Periodperiod2 
You Are What You Eat
It's that time of the month, and you're tired, irritable and bloated. Though you'd much rather reach for a bag of potato chips than trail mix, eating poorly will only make your symptoms worse. Find out which foods can make your monthly cycle more manageable and follow these simple do's and don'ts.

Do eat complex carbohydrates
Fruits, vegetables and whole foods are your friends always, but especially during menstruation. The fruit from sugar may help alleviate sugar cravings. You can also try adding apricots, oranges, plums, pears, cucumbers, artichokes, corn and carrots to your diet.

Don't drink caffeine
Cutting back on caffeine intake can help reduce bloating and calm an irritable stomach. Caffeine can increase stomach acid and be rough on sensitive intestines.

Do eat calcium-rich foods
Women need at least 1,200 mg of calcium every day. Some good sources of calcium include kale, collard greens, broccoli and yogurt.

Don't eat too much salt
Though salt is crucial to good health, bloating and water retention can occur if you overdo it. Nutritionists recommend a diet with 2,300 milligrams/day, or roughly one teaspoon. The best way to control salt intake is to avoid processed and fast foods, many of which contain three to four times the salt you should have in one meal.

Do indulge in dark chocolate
Eyeing that chocolate bar? It's OK -- give in! Having a piece of dark chocolate (with 60 percent or higher cacao bean) every day during your period will help soothe cravings. Plus, dark chocolate has helpful antioxidants and is linked to boosting serotonin, which can help improve your mood.

Don't skip the water
This one may not feel intuitive, but drinking more water will help your body release water retention and alleviate bloating. Your body is retaining water because it's afraid of not getting enough. So, if you give it what it needs (more water) it will release the water it's holding onto.

Do eat magnesium-rich foods
Foods rich in magnesium like beans, tofu and peanuts are thought to reduce bloating in menstruating women.

Don't forget your vitamins
Try adding vitamin-friendly foods to your diet, especially during your cycle. Vitamin E can help eliminate some PMS symptoms; you'll find it in avocado, hemp seeds and egg yolk. Vitamin B6 can help relieve bloating and boost your mood; find it in potatoes, bananas and oatmeal. Lastly, vitamin C and zinc support the health of a woman's eggs and reproductive system. Find vitamin C in grapefruits and lemons and zinc in pumpkin seeds and squashes.

Source: She Knows

Twins Separated at Conceptiontwins3
By Art Castelbaum, M.D., RMA of Jefferson

I frequently receive pictures and cards from patients who have successfully undergone fertility treatment. My favorite is a picture of an older and younger child. In a sense, they were twins separated at conception. The older child was the product of a fresh In Vitro Fertilization (IVF) embryo transfer. The younger child was the result of a cryopreserved embryo from that same IVF cycle, subsequently thawed and transferred into the Mom's uterus.

The majority of women under the age of 35 will have sufficient embryos available during their fresh IVF cycle so that extra embryos can be frozen. By using a more sophisticated freezing technology called vitrification, frozen embryos can be viable for many years. In my personal experience, I have had successful pregnancies with embryos frozen for almost a decade.

Most couples use their frozen embryos when their youngest child is a year or two old. Excellent frozen embryo transfer pregnancy rates can be achieved using a patient's own natural cycle if she ovulates every month. Alternatively, oral estrogen can be used for two weeks to prepare the lining of the uterus. Because of the advancement in freezing technology and the effectiveness of frozen embryo transfer procedures, I do not recommend transferring more than a single frozen blastocyst embryo for women under age 35 or two blastocyst embryos under age 41.

The last 30 years have seen a dramatic increase in the incidence of twin and triplet pregnancies in the United States. Fertility doctors have been largely responsible. 1 in every 30 infants born in 2009 was a twin; double that of 30 years ago. The serious risks of triplet pregnancies are generally well understood. Most people, however, believe that twins do great.
Surprisingly, 25% of twins require neonatal intensive care hospitalization, and the risk of cerebral palsy and even death are significantly higher for twins compared to a single baby. Transferring a single blastocyst embryo avoids these complications.

Several recent studies have suggested children conceived with frozen embryos may have better health compared to those conceived during a fresh cycle. I think it is too early to tell whether the findings in this study are correct and that larger, longer term studies are necessary. However, this study does give us confidence that the use of frozen embryos as a routine part of fertility treatments is an excellent option. 

Dr. Castelbaum is currently seeing patients at the Yardley office of Lawrence OB/GYN. Please call 267-852-0780 or visit RMA Specialists to learn more about Dr. Castelbaum and RMA at Jefferson.

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