Here is a post from my dear friend Dr Howard Elkin. The timing of his post was spot on as we had just gone over my latest blood work results.

I do my blood work at least twice a year and my previous results were from April. At 50 they showed a slowing down but nothing too drastic, my most recent results, however, put me right in menopause, all my hormones had taken a dive. Thankfully I actually feel pretty good, I have found myself worrying a little more but I put that down to some pretty major life changes this year (Moved to a different state, left my business in CA, had major surgery) I know so many women really struggle with this time of life and I certainly am not one to go down without a fight 🙂

Here is the latest post by Dr Elkin, be sure to follow him on his blog


Most folks remember the results of the WHI (Women’s Health Initiative) released in 2002. Basically there was an increase in cardiac risk, blood clots and breast cancer in those using estrogen.However, what you might not remember is that the average age of the women in this study was 61 (making them clearly postmenopausal),an age where one would certainly expect to see heart disease. Also, the hormones used were equine estrogens,derived from the urine of pregnant horses. Most importantly all these estrogens were administered orally. Oral administration ensures that all drugs undergo the ” first pass ” effect in the liver, it’s been shown that many of these estrogens metabolize in the liver to inflammatory compounds..NOT GOOD

This study which has one disadvantage in being observational in nature, studied over 45,000 women over a period of 7 years. There was no increase in breast cancer , stroke or heart disease.

This is promising news. I have always prescribed topical /intra-vaginal estrogen for many years. Using bio-identical hormones, seeking hormonal balance, and knowing how to test HRT in an ongoing fashion is the key to safe hormone administration.

PHILADELPHIA — Vaginal estrogen use was found to be safe among postmenopausal women, researchers reported here.

In the prospective cohort study, Carolyn J. Crandall, MD, MS, of the University of California Los Angeles, and colleagues, found vaginal estrogen use was not associated with any increased risk for a global index event (GIE) (HR 0.69, 95% CI 0.59-0.81).

Presented at the annual meeting of The North American Menopause Society, the findings were similar among users with an intact uterus (HR 0.63, 95% CI 0.51-0.77) or who have undergone a hysterectomy (HR 0.83, 95% CI 0.63-1.08) after adjustment for age, education, prior estrogen use, and a history of cancer, CVD, or DVP/PE.

Crandall explained to MedPage Today that her group wished to conduct this study because there was an absence of long-term data of a large cohort of those who used estrogen vaginally.

Based on results from the Women’s Health Initiative, the FDA requires warnings on all estrogen formulations.

She noted that “even the vaginal estrogens are required to have a black box warning that says ‘caution, increased risk of stoke, breast cancer, possible dementia,’ etc. And so currently, many leaders in the menopause field are wondering about whether that class labeling is unfair, essentially based on inadequate evidence, and they want to see whether that ought to be reconsidered.”

The prospective cohort study with data from Women’s Health Initiative Observational Study included 45,663 postmenopausal women age 50-79 from 40 centers. None of the participants used system estrogen therapy during the median 7.2 years of follow-up. Vaginal estrogen use was self-reported by the women and included use of a cream or suppository.

Crandall’s group also found no increased risk among individual cancer risks factors among the entire cohort of users with or without a uterus:

  • Breast cancer: HR 0.86, 95% CI 0.62-1.18
  • Colorectal cancer: HR 0.72, 95% CI 0.41-1.25

Similar findings were also reported regarding cardiovascular risk:

  • CHD: HR 0.44, 95% CI 0.29-0.69
  • Stroke: HR 0.63, 95% CI 0.40-0.98
  • PE/DVT: HR 0.59, 95% CI 0.33-1.05

Hip fracture risk was also not elevated among the entire cohort of users (HR 0.49, 95% CI 0.26-0.92).

The biggest take-home message from these findings is reassurance to clinicians regarding the lack of any increased associated risk for heart disease, stroke, of cancer among vaginal estrogen users versus non-users, Crandall highlighted, adding that she wasn’t particularly surprised to see these results.

Despite the several strengths of the study, including the large cohort, long follow-up period, and strict control of the variables, the findings are limited to the observational study design.

“Are those women using vaginal estrogen healthier for whatever reason, and that’s why they didn’t have heart disease and stroke and breast cancer? Maybe because they’re thinner, they exercise more, access to medial care — we tried to control for everything, but we can’t rule it out that there could be some systemic effect. I think that would probably be the one caveat of the study.”

Be sure to subscribe to Dr Elkins Heartwise blog!


In 2009 I met the man who would become my husband and change my life forever. Meeting Kevin was the highlight of that year but coming in a distant second was an event that you may feel was more significant. In 2009 three people shared the ultimate prize, awarded for their work which shone new light on how we age and the power we have within ourselves to control the process. This anti-aging answer you will not find in a bottle.

In 2009 Elizabeth H Blackburn, Carol W Greider and Jack W Szostak won the Nobel Prize for their discovery “How chromosomes are protected by telomeres and the enzyme telomerase”

full article link

In 2009 three people told us why we age and what we can do about it.

Despite my fascination, I have to re-read this type of scientific literature many times to grasp it. I then have to get busy with a highlighter and rewrite it in my own words. The topic of telomeres is exciting and affects us all, but I do hope I don’t insult the three Nobel Prize winners with my incredibly simplified translation of their life’s work.

As human bodies, we are made up of organs. Organs are made of tissue, tissue is comprised of cells and each cell has a nucleus.

Inside the nucleus of a cell we have chromosomes. Chromosomes contain packets of information, this information is our genetic code, our DNA.

DNA (deoxyribonucleic acid) is that spiral ladder diagram you’ve seen before. Each rung of the ladder is a pair of nucleotides. Nucleotides are the units that store our unique information. Chromosomes are tightly coiled strands of DNA; we have 23 chromosomes from each parent.

To say it in reverse, chromosomes are strands of DNA. Chromosomes are found in the nucleus of cells, cells make up tissue and we have lots of tissue.

Think of a chromosome as a shoelace that has those plastic protective tips on the ends. Every piece of our data is stored in these shoelaces with plastic tips. The Nobel Prize was awarded for research on those plastic tips – our Telomeres.



We all started from one single cell and for us to grow that cell had to duplicate and each cell after that had to duplicate (Mitosis). One parent cell divides into two daughter cells and each daughter makes copies of the information packets (chromosomes). A cell can only divide so many times (called the Hayflick limit) and when the cycle stops the cell dies. Changes in our skin and hair are annoying but there becomes a real problem when the cells of the immune system can no longer divide.

Chromosomes hold all our personal data and to ensure that information is copied successfully each chromosome has that plastic tip, that telomere. With each cell division the telomeres shorten in length and when a telomere becomes too short, the information (chromosomes) cant be copied and the cell becomes old and dies (apoptosis).

It’s the reduced length of the telomere that has been linked to the aging process. Telomeres protect our chromosomes and much like that shoe lace, problems arise when that plastic tip gives out.



Chronic stress reduces the length of telomeres. People who care for sick children showed a reduced telomere length. The shortening corresponded to the length of care and was not a function of the caregiver’s age. A young caregivers telomere reduced in length at the same rate of a person much older. On a promising and quite miraculous note, researchers were able to stop the telomere shortening by implementing stress management techniques. In some cases, just 12 minutes of meditation a day for two months was shown to protect telomere length. For parents of hospitalized children or for the long-term carers of autistic kids the implications are huge.


Ladies with cervical cancer were studied and the results were similar. The ladies were given both mental, and physical counseling and their symptoms improved. Dr. Nelson (University of California, Irvine) went one step further and upon reexamination, he found that the counseling had not only stopped the shrinkage, but it had also promoted telomere growth. The study participants still had cancer, that hadn’t changed, but they had longer telomeres at the end of the study than they did at the start!

These incredible results tell us how positive thinking, social support, belief, attitude – faith can dramatically help with health, healing and the aging process.


Telomere length is a function of length erosion and length addition. Stress, sickness, age will cause a telomere to shorten and it’s the enzyme Telomerase that is responsible for any growth.

Telomerase is found in fetal tissue, adult germ cells and in tumor cells. Body (somatic) tissue tends to age and die because of its very limited telomerase activity. If this enzyme (enzymes speed reactions) is activated, a cell will continue to divide. It’s called the “Immortal cell theory,” but it’s not as good as it sounds. The body as a whole is a system of regulators, brakes, and accelerators that are used together to find a place of balance. If we just slam on the accelerator it might seem great at first, but there will be a long-term price to pay. We see this with obvious behaviors such as very restricted dieting, excessive exercise or massive sleep deprivation. You might lose weight initially, hit a personal best or get that study paper in on time – but there will be consequences.

If telomerase can keep a cell dividing it might seem great for anti-aging but quite frightening if that cell is a cancer cell.

Cancer cells are malignant cells which divide and multiply to form a tumor; telomerase is found to be 10-20 times more active in a cancer cell than in a normal cell.

An immortal body with mere mortal disease.

What if we could activate telomerase activity in our aging body cells while turning it off in cancer cells?


The goal is not to live forever, but to live forever in great health, a dream that is one step closer to being a reality thanks to the Nobel Prize Winners of 2009.

Today 40 is the new 30 and someday maybe 100 will be the new 65. We live in exciting times that are pushing us to look beyond the physical.

In times of intense stress, it can be hard to hold a positive thought. One of those bestsellers told us how negative energy is 6 times stronger than positive energy. How one negative person can infect a whole office whereas one brave positive soul cannot. It is great to know that positive outcomes come from positive thoughts but in times of such stress it’s hard to go it alone.

With a plethora of best-selling books about awakening giants, thinking to grow rich and being better than good, this is not totally new to us. We pay thousands of dollars to be told how our thoughts create our reality and this is a giant size 16 step in that same direction.


This research will expand the role of structured support for the sick and for those caring for the sick. The undeniable proof that our thoughts can change us on a cellular level brings with it a new level of personal responsibility to be kind to ourselves and to care for others. When we feel powerless there is more we can do than just hand our loved ones over to the doctors. We can listen, give of our time and be of comfort. We now know that these acts are what keeps the shoelaces tied, they are what makes another step possible.

Belief besets attitude and attitude can literally turn back the hands of time.

Be kind to yourself.

More about Joanne HERE

joanne lee cornish












How To Avoid Temptation

I love numbers, so I really love all the fitness gadgets that are out there. From the Fitbit to all the apps we have available to us, we really don’t have to leave anything up to guesswork anymore.

I’ve been helping people lose fat and/or gain muscle for 25 years and I can talk and explain until I’m blue in the face but there’s one gadget that clears all the confusion and answers a lot of questions.

How to avoid temptation and stay on point with your diet nutrition on point


A blood glucose meter measures the amount of carbohydrates (aka sugar) in your blood. If the number is too high then the excess sugar will block the release of stored bodyfat.

The body has two main fuel sources, carbohydrates (sugar) and fat (dietary and bodyfat) we really dont want high levels of sugar in the blood so when that happens the hormone insulin traps fat in its storage location (ie you belly, hips, thighs etc) so that no other fuel is available and the excess sugar has to be used or stored away.

Every single weight loss diet is trying to control blood sugar and insulin, they can slap any label on the product but this is what they are ultimately trying to do if the goal is weight loss.


Eating is fun, it makes us happy. It’s the heated conversation we have in our own heads as to why we should and why we shouldn’t eat our favorite foods.

  1.  You’ve been good all week, you deserve pizza
  2.  You did cardio every day, you deserve pasta
  3.  It would be rude not to (OMG)

We have any number of good reasons to fall into temptation and fall off a diet. As a nutrition coach this used to be a major obstacle.

What keeps most people on a diet is willpower combined with a really huge WHY.  Losing weight for a pool party and losing weight following heart surgery are two very different motivators. Willpower will match the desire to a point but willpower is very much like a muscle and it tires and fatigues. On average willpower lasted 3 weeks – sound familiar?

I provided my clients with documents and videos, I wrote and presented weight loss seminars and asked them to journal daily. Knowing something and having someone breathing down your neck definitely helps you keep on track but I couldn’t be there at dinner with my clients, I couldn’t steer their car away from every drive through. We’re all human, we get frustrated, we get tired, we lose sight of the prize and temptation is right there waiting for us, in the form of a dessert or cocktail.


In about 2005 as well as explaining blood sugar I started testing it and soon after every new client left my office with the pocket-sized device. Initially, I asked clients not to change anything but to test their blood sugar 30 minutes after a meal and to let me know anytime the number went over 140. The emails and texts soon followed.

Frank … OMG Joanne, I thought I was making such a great choice with chicken sliders – 195

Juliette ..  WT% my green juice 178

Terry .. Champagne took me to 165

I guarantee Frank will never order those sliders again and I know Julliette changed that green juice.

Sometimes its hard to relate what we put in our mouths to our body weight so what the blood glucose/sugar meter does is it makes it all very real. More importantly, people make better choices all by themselves.

blood glucose testing


I usually ask clients not to eat for 90 minutes before our first appointment. If I am meeting them in person I will be checking their Metabolic rate and it’s more accurate on an empty stomach. If I check their blood sugar and the reading is high (say above 150) then it tells me that we might have other issues going on and weight loss might take a while.

A reading south of 100 first thing in the morning and a reading not higher than 120 post meals is a good place to start and easily attainable in a healthy individual. If then we move to a lower carbohydrate diet and higher fat we might push to keep the blood glucose reading under 100.

The power of the reading is two fold

  1. It stops a lot of wasted conversations. People love to justify why they need to eat something. Go right ahead, just let me know the reading.
  2. It’s a real kick when you see a great number show up. It motivates and keeps people on track.

The reading may also illustrate the power of non-food issues on your weight. Stress and sleep have a direct impact on blood glucose.

I don’t hear of most weight loss coaches checking blood sugar and I do wonder why. Maybe they feel it is too much to explain or that a client would not be interested. From experience, I can tell you it really ignites peoples interest in the process. Watching the penny drop as a person connects their eating to their health thrills me every time and even in a years time, when they cant, remember my name, I know they will remember that reading.

You can purchase a blood glucose meter at most pharmacies or BUY HERE














CARBING UP or PEAK WEEK involves eating large amounts of carbohydrates before an event, but is it really worth it?

If you’re involved in endurance sports you may have been told to “carb up” for an event. The theory being, that if you eat a lot of carbohydrates, they will be transported into your muscle to fuel your big day.  Let me tell you from experience, there are so many things that can go wrong here. It took me my first ten years of competing to get this exactly right, so it is very VERY doubtful that an online coach or social media ‘guru’ will nail it for you. Unless you’re working with someone that really knows how to manipulate your nutrient intake, you’re more likely to get it wrong than to get it right. Too many carbohydrates at the wrong time will make you tired, sluggish – and fat. Is carbohydrate loading really worth it?

carbing up yes or no?

Carbohydrates trigger insulin and …

Insulin can take carbohydrates into muscle.

Muscle stores carbohydrates as “Glycogen.”

Glycogen will fuel that muscles activity.


There are a couple of keywords to pay attention to here.

Insulin CAN take nutrients into muscle – but sometimes it CANT

Glycogen will fuel THAT muscles activity – it will not fuel ANOTHER muscles activity.


Glycogen is the form in which carbohydrates are stored in the muscle and the liver. To simplify the terminology

  • Carbohydrates are on your plate
  • Carbohydrates in your blood are called Blood Sugar aka blood glucose
  • Carbohydrates in your muscle (or liver) are referred to a Glycogen.

If we freeze water, we call it ice, if it falls from the sky we call it rain and if we play in it we call it snow.  When substances take different forms, we give them different names.

Never let terminology intimidate you.


There is a limit to how much glycogen a muscle can store.  The larger the muscle, the more glycogen it can hold, and a conditioned athlete can store more glycogen than a normal person.

You cannot put two quarts of water in a one-quart jug.

Muscle is not a bottomless pit. Every muscle has its own storage capacity.

A person may hold between 1500 and 2500 calories worth of glycogen in their muscles, which translates to 7-8 grams of carbohydrates per lean pound of body weight. That is not that much, especially as muscle is rarely empty. Unless you’ve gone to deliberate measures, like doing a 24 hour fast or doing several hours of cardio, your muscles will be storing some glycogen.

In bodybuilding to increase the accuracy of our efforts, we would carb deplete for several days before doing the ‘carb load.’

George eats 3000 calories a day with 85% of his calories coming from carbohydrates (not an unusual occurrence).  That would be 637 grams of carbohydrates per day.

George lives in Los Angeles, drives to work and sits at a desk all day.  George is overweight and is getting heavier every year.  George is eating more carbohydrates than, his muscles can store. Thankfully (not) his fat cells have no such limitations and will happily store excess for George.

Thomas eats 3000 calories a day, 60% of his calories come from carbohydrates, that would be 450 grams of carbohydrates per day.  Thomas lives in New York, walks to work, lifts weights and is in a rowing club.  Thomas is not overweight.

In today’s society exercise is becoming more of an option, perhaps even a luxury. We drive more, our work is less manual and our time is limited. Muscles are not depleted, and eating patterns are carb heavy.

Insulin promotes fat storage, and how we eat and how much we move determines what role insulin plays in our lives. Food will dictate the insulin response and exercise will determine where the nutrients end up.

When you exercise a muscle, you deplete the glycogen stored in that muscle. If we exercise consistently, we create space where new glycogen can be stored. “Exercise” does not mean a gym membership or a pair of running shoes, an active lifestyle requires a lot of muscle activation and so depletes muscle glycogen stores. You don’t see many fat guys doing construction.

After a meal, the amino acids (protein) and blood sugar (carbohydrates) go to your small intestine where blood vessels absorb them and take them directly to the liver. The liver takes up most of the nutrients you just ate, (first pass metabolism) and can store about 100 grams of glycogen. Excess carbohydrates are converted into fatty acids and stored as (you guessed it) fat.

It is liver glycogen that can leave its host, travel in the blood and provide fuel for other bodily functions. Muscle glycogen cannot.

If your blood sugar drops because of missing meals or creating your own food coma, being buff won’t help you

Glycogen is also stored in the liver (about 100 grams) and this glycogen (not muscle glycogen) is used to fuel most of our bodies energy requirements. Liver glycogen is replenished first. Muscle glycogen pretty much stays put until that muscle uses it.  Muscle glycogen cannot help if your blood glucose level drops – only the liver can help with that.

Carbohydrates can be stored in the muscle and liver as glycogen. Both have their own storage capacity. Fat has no such limit. Sugar with nowhere to go will be converted into fatty acids and stored in our fat cells. Fat cells increase in volume to oblige our uninformed choices

A gentleman did his first marathon, gained 10 lb and came to see me. He was furious. He went from inactive to running four days a week. Understandably his appetite increased and was encouraged to eat a lot of carbohydrates to fuel his runs. He gained 10 lb

As a personal trainer, I signed up for a weekend course to be a running coach.  Most of the attendees worked with novice runners, organizing running clubs and charitable events. I learned a lot, but was excited for day two when they were to cover nutrition. I’ll never forget that the module, which should have been an hour and was completed in 15 minutes, was summed up by the instructor (an ectomorph) telling the coaches “get your clients to eat well and running will take care of the rest.”

I would suggest that the majority of people that join a running club do so to get in shape. I would also guess that most recreational runners are not ectomorphs. When the well-meaning, passionate coaches are not given the guidance that they need, then we end up with angry men knocking on my door.

‘Carbing up’ or as it is now called “peak week” may work for you but it can very easily work against you too. If endurance is your game my advice would be if you dont deplete you dont need to carb up. If you’re taking the stage then there is a little more to gain from this type of nutrient manipulation, although more often than not competitors miss their mark by not carbing up and looking a lot better a few days after the show.

Preparation is the best course of action so if you have a competition or event plan to do a practice week about 4-6 weeks before the big day. A practice week will allow you to evaluate results and performance.  Above all, remember your goal, if you’re competing but your ultimate goal is to improve your body composition then carbing up is not likely to move you towards that goal

Until next time




joanne lee cornish