Let’s Talk Sex: What About Lubrication?

Flickr/Tela Chhe

Flickr/Tela Chhe

Female lubrication can be a problematic and troubling issue. It varies from person to person and from encounter to encounter. Sometimes, lack of lubrication is related to “not being in the mood” or not receiving adequate stimulation prior to intercourse. Other times it is related to having too much activity in too short of a time – the vagina tires out and cannot make enough moisture. And some other times it comes with normal body changes as we age, such as menopause.

These are very different causes for lack of lubrication and thus require very different solutions. The real problem is, deciding which problem you have and then is it the same problem every time?

Women take longer to get excited than men. A woman requires stimulation – both emotional and physical. If a woman tries to have sex without adequate stimulation she will not lubricate. Sometimes employing a lubricant or gel and adding that to foreplay will increase sensitivity, lubrication and receptivity.

If a woman has too much sex in too short of time period, the vagina can fatigue and not produce adequate lubrication. This is a normal physiological response and it generally reacts well to the use of a cream, gel or lubricant. Some women taking birth control pills have problems with vaginal dryness and finds gel helpful during intercourse. Some women going through menopause finds lubrication and arousal a difficult task as well.

There are many different gels available in the marketplace. Some employ menthol, some nicotinic acid, amino acids, etc. Some will increase blood flow to the genitalia and this should help with dryness and responsiveness.

Remember, vaginal lubrication is both physical and emotional. Spend time touching, kissing, cuddling, talking and getting “in the mood” before becoming intimate.

-Dr. Robert Feldman M.D. – Obstetrics and Gynecologist

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The Most Common Disease Your Doctor Has Never Heard Of

MN_graphic_RLS_grant copy

Restless leg syndrome (RLS) is a disorder characterized by:

•             A disagreeable, uncomfortable sensation in the legs, accompanied by

•             An irresistible urge to move the legs, which is

•             Worse at night and when lying down, with the

•             Discomfort eased with movement, stretching, or walking.

RLS effects about 8-10% of Americans.  Although the symptoms can occur at any time during the 24 hour day, they are typically most troublesome at night, when the person becomes inactive and lies down to sleep.  The usual causes unknown, although it can occur in association with other medical conditions such as iron or vitamin deficiency, kidney disease, arthritis, pregnancy, diabetes, nerve damage, and Parkinson’s disease.  The disorder often appears to be more common in females and becomes more common as people become older.

The symptoms of RLS include sensations deep inside the legs, often described as:

  • Creepy–crawly
  • Pulling
  • Itching
  • Jittery
  • Burning
  • Ants crawling
  • Elvis legs
  • Bubbling water
  • Tugging
  • Painful
  • Prickling
  • Heeby  jeebies

Although in years past this disorder was often not fully recognized until 10-15 years after symptom onset, the medical community is now much more aware of RLS and able to offer an appropriate diagnosis and treatment regimen. Therapy often consists of conservative measures such as warm baths, massage, moderate exercise, along with avoidance of caffeine and certain medications which may worsen the symptoms.  Generally, good sleep hygiene (sleep habits) is appropriate.  Treatment of the underlying medical condition may also be warranted.  Also, prescription medications maybe indicated.  Your sleep specialist will be able to determine which treatment option is best for you, to finally let those Elvis legs go to sleep.

-Dr. Tim Grant M.D. – Neurologist and Sleep Specialist

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Brain Benefits of Omega-3 Fatty Acids

Flickr/Alexis Fam Photography

Flickr/Alexis Fam Photography

Remember the old saying about an apple a day keeping the doctor away? It seems like now fish can do that, or maybe better! Not only omega-3 fatty acids -found in certain fish- have been associated with healthy heart and metabolism but it seems a healthy dose is also capable of helping keep our brains whole!

A new study analyzing data from the Women’s Health Initiative Memory Study has shown older women with higher levels of omega-3 fatty acids in their blood had slightly less brain shrinkage. This could protect us from the volume loss that happens normally with aging and is more severe with dementia.

The study was conducted to see whether omega-3s were associated with just brain loss in general, but also to look into specific brain regions involved in memory and other cognitive processes.

Omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) is found in all cells in our bodies. In particular DHA accounts for 30-40 percent of the fatty acids found in brain cell membranes.

Levels of omega-3s were measured in red blood cell levels, which is a good indicator of how much omega-3 a person has consumed. The study found that women with the highest EPA and DHA blood levels had brains that were about two cubic centimeters larger overall than women with the lowest levels.

So let’s eat our Tuna…. to health! Or rather… to brain!

– Dr. Jack Miodownik-Aisenberg M.D. PhD – Internist

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MN_graphic_ask_ copyChronic diarrhea can be the harbinger of significant medical illnesses. Definitions vary but most would agree that more than 3-4 loose watery bowel movements a day lasting for several weeks.

Certainly in young healthy individuals irritable bowel syndrome or IBS is quite common however. One should be concerned if diarrhea lasts longer than a week and is associated with fever, weight loss, pain, bleeding, or skin rash.

Common causes of chronic diarrhea would include infections, inflammatory bowel disease (Crohns Disease and Ulcerative Colitis), celiac disease, medication or supplements, lactose intolerance, and relation to other medical issues.

It would be important to see a physician and have a thorough history and exam. In addition routine blood work should include CBC, Chemistry, C-reactive protein, Thyroid function, iron, B12, folate, and tissue tranglutaminase (blood test for celiac sprue). Stool analysis should beobtained for white blood cells, culture, ova and para cites, clostridium difficile antibody, and fecal fat. Depending on results of the above a colonoscopy or upper endoscopy should be considered. If a diagnosis is made appropriate medical treatment will be given. Often no underlying cause is given and a diagnosis of Irritable Bowel Syndrome is made. We’ll further discuss IBS next week, so stay tuned.

-Dr. Howard Schwartz M.D. – Gastroenterologist

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5 Nutrition Tips for Smart Weight Loss

Eating to lose excess weight tied to body fat can be daunting. To some people, eating for weight loss feels more complicated than it really is. It is understandable that if just starting out on changing your nutrition meal plans and daily-eating habits coupled with starting a new exercise program, that it can be overwhelming. The goal here is help make your success easier.

Tips to make part of your daily habits

  1. Start a journal.  Yes, whether through a blog, an app or on old fashioned paper, on a daily basis write down your goals for the day. This could include trying a new food, experimenting with exercises that you have not tried before, planning your meals for the day and of course at the end of the day, write down what you ate, drank, what your moods were throughout the day and what you achieved versus goals to continue to work on. Here is a great website and APP that helps make journaling easier: http://www.myfitnesspal.com
  2. Find a buddy. Data shows us that those people who have a friend/partner that they are verbally sharing their goals with and also exercising with are more apt to stick to the plan and achieve their goals. There is something to the act of committing to another person and to each other to eat a tad less and cleaner foods along with exercising together that makes the process easier. You can even find a buddy here: http://www.weightlossbuddy.com. Once you feel responsible to yourself and someone else, who likes to like anyone down?
  3. Start your day with protein-centric foods. We know that people who eat protein with every meal feel less hungry throughout the day and tend to eat less than others who eat purely high-carbohydrate diets. Protein makes the body also burn extra calories aiding in your workout and weight loss goals. Here some great protein based breakfast ideas http://www.rd.com/slideshows/high-protein-breakfast-ideas/
  4. Choose a time to exercise daily. If you schedule your exercise just like you would schedule a doctors appointment or a massage, than it too can become more routine as part of your day. Also, if you do not like exercise, try taking various classes offered by your local gym, whether it be Zumba®, step aerobics, yoga, box-aerobics or such, engaging in classes is a sure way to exercise. Aim for at least four to five workouts per week. Here is a calendar that allows you to schedule workouts http://doodle.com/?locale=en
  5. Do not be afraid to meet with a Registered Dietitian. RD’s are board certified specialists in nutrition who can help you craft a nutrition and meal plan making it easier for you to achieve your goals. RD’s can also help coordinate local chefs to work with you for prepared meals to specific nutrition macronutrient ratios known to aid in weight loss. This link can help you find a RD near you: http://www.eatright.org/programs/rdfinder/

To your success!

– Douglas S. Kalman PhD RD

To continue to learn more about health and whole body nutrition, please follow us on Twitter @Miami_Nutrition or my Twitter, @dougkalmanphdrd

A Touch of Intimacy Goes a Long Way

Image courtesy of tmarsee530 via Flickr

Image courtesy of tmarsee530 via Flickr

Everyone is talking about intimacy in their relationships – and if they’re not, they should be.  Intimacy, which can be defined as how comfortable we feel when we interact with someone either sexually or emotionally, serves as a great barometer for the overall health of our relationships.  Couples who experience high levels of intimacy, either sexual or emotional, report higher levels of satisfaction in their relationships.  And in turn, people who are in intimate relationships report being happier and having greater life satisfaction.  Intimacy can be hard to attain – women are supposed to be in search of it and men are supposed to be afraid of it.  Regardless of whether these stereotypes are true, there is a clear benefit to being in an intimate relationship and any effort you make to increase intimacy in your relationship will pay off dividends.

Now, a recent study seems to suggest that the simple act of touching is associated with greater intimacy in relationships.  The past several years has seen an increase in research showing the positive effects that touch can have on our physical and psychological health.  A group of researchers at the University of Zurich had dating couples keep diaries of the frequency and the effects of touching.  Their results showed that couples that touched more often – either through holding hands, giving a massage or enjoying a warm hug – reported feeling happier and experiencing more intimacy than couples who didn’t.  Of course, it is possible that couples who feel more intimate with each other engaged in more touching, but regardless of the association, the benefits of touching were quite clear.  We all know that relationships can be a struggle at times.  Good relationships don’t just happen, and we should all make the effort to find ways to attain and maintain intimacy and happiness with our partners.  The results from this study provide us with a simple ingredient that may contribute to a satisfying relationship.  Go ahead and touch as often as possible and see if it serves to bring you and your partner closer together.

For more daily health enhancing tips and living, please stay plugged into to this blog and follow us on Twitter @Miami_Nutrition

-Dr. Rafael Rivas-Vasquez PsyD – Physchologist

Fountain of Youth

Image courtesy of tiinaI91 via Flickr

Image courtesy of tiinaI91 via Flickr

All of us want to be stronger… and think clearer… and have better sex. And while there is a whole medical system built around helping us to achieve those goals, one of the first places to start is very basic and quite often overlooked – sleep!

True peaceful slumber, not half asleep in front of the TV in the bedroom, not dosing in the chair while watching the evening news, and however refreshing little cat naps at the desk may be, not even that. Our bodies are built to refresh and regenerate during deep stages of sleep, it allows our brain cells to reboot if you will and recharge, form memories, and clear the stage for intellectual activities in the day ahead. Our old cells and shed and broken down and new healthy cells generated during sleep, helping our skin to look better and our organs to function better. Our kidneys are flushed through and muscles refreshed. Getting an adequate amount of deep sleep also improves mood and strengthens sexual desire and function. It is the true fountain of youth!!! And of course the most elusive in the modern world.

Our lives get in the way of good sleep. We are overwhelmed by the demands on our time from work and life stresses and are bludgeoned by electronic stimulation from televisions, tablets, computers, smart phones and the latest gadgets. It is increasingly more difficult to separate yourself from our electronic toys to allow your brain to focus on preparing for sleep. But research shows that you need at least 60-90 minutes free of screen time for you to do just that. Additionally sleep experts recommend no exposure to screens in the bedroom at all. That means that phones/televisions/laptops – all have to be left outside. The bedroom should be a sanctum for rest and relaxation, and of course the occasional romp under the sheets. Reading a calm book, taking a hot bath, and drinking a hot beverage like milk or tea is a very easy way to start preparing for deep refreshing slumber. Give it a try.

For more daily health enhancing tips and living, please stay plugged into to this blog and follow us on Twitter @Miami_Nutrition

-Dr. Olga Kromo M.D – Rheumatologist

Turmeric: The Miracle Root

Image courtesy of Steven Jackson Photography via Flickr

Image courtesy of Steven Jackson Photography via Flickr

Turmeric (Curcuma longa) is a plant belonging to the ginger family.Turmeric grows wild in the forests of South and Southeast Asia and is used in many Asian dishes. Although typically used in its dried powdered form, turmeric is also used fresh, like ginger. It is widely used as a spice in South Asian and Middle Eastern cooking

In the Indian tradition turmeric has been used for thousands of years to help with stomach and liver ailments, as well as topically to heal sores including eczema, chicken pox, shingles, allergies, and scabies. In the Auyurvedic tradition, turmeric is used as treatment for a range of conditions including skin infections, aches, pains, sprains, pulmonary and gastrointestinal ailments.

Its active ingredient curcumin has an earthy bitter taste and a mustardy smell. Curcumin is believed to have a wide range of biological effects including anti-inflammatory, stabilizing metabolism in diabetes, cancer-fighting, antibacterial and antiviral with potential to treat an array of diseases including cancer, Alzheimer’s disease, diabetes, allergies, arthritis and other chronic illnesses. Hundreds of scientific studies have dealt with the notion of establishing whether there is healing qualities in this humble yellow root.  There are many studies still being conducted.

Who should avoid high doses of turmeric? Curcumin is a blood-thinner and may delay blood clotting. People on Warfarin or similar medications should be careful, as should pregnant women, immunocompromised patients, and those anticipating surgery. Always ask your doctor when in doubt. And of course it is not a magical panacea! We still need to do our part by keeping  a healthy lifestyle with wholesome nutrition based on natural whole foods, regular exercise, restful sleep and avoidance of smoking and stress.

There are many good reasons for cooking with turmeric. One of them is its vibrant yellow color which brightens our mood as well as its pungent flavor that spices and awakens our senses. Another reason is that it’s good for you. Fancy a turmeric smoothie?  Mix some natural yogurt or almond milk with frozen or fresh berries, bananas, ground turmeric, freshly grated ginger and honey. Drink to your health!

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-Dr. Jack Miodownik-Aisenberg M.D. PhD – Internist

Ask the Gastroenterologist: Acute Diarrhea

Dr. Howard Schwartz

Dr. Howard Schwartz

Acute diarrhea is one of the most common reasons for visiting your doctor. Most Americans have 2-3 “attacks” of diarrhea a year.

Common Causes

1. Viral Gastroenterits comes from food and typically is a self limiting illness that last 24-48 hours.
2. Bacteria causes of diarrhea range from a toxin in food to invasive bacteria. Most resolve without treatment in 3-5 days.
3. Food intolerance can range from a reaction to spices and cream to individuals who are intolerant of lactose or sorbitol which is a sugar substitute.
4. Medications and supplements can cause diarrhea. Special concern for clostridium difficile which is an infection that comes from antibiotics.

The best way to treat diarrhea is to avoid it. Try to only eat well cooked food and avoid buffets and food that has not been properly covered and refrigerated. Raw food is of special concern and make sure it is from a good source. Pay attention if symptoms are related to a medication or food so you can avoid in the future. One should be concerned and make sure to seek medical attention if the diarrhea is associated with fever, blood in the stool,severe pain or dehydration. Populations at special risk include the elderly, infants, and people who are immune compromised.

Next Chronic Diarrhea

-Dr. Howard Schwartz M.D. – Gastroenterologist

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3 Great NutraTips for 2014!

Image courtesy of thepinkpeppercorn via Flickr

Image courtesy of thepinkpeppercorn via Flickr

Here are three easy to implement nutrition tips that can add quality and health to your life:

1. Try and Add Ancient Grains to your diet

Quinoa, barley, beans, bulgur and sweet potatoes are all considered “good carbs.” Unprocessed and filled with fiber, these should be your nutritious carbs of choice in 2014. Forget the white rice: half a cup of cooked barley contains just 99 calories, negligible fat, 23 grams of carbs and two grams of protein. This side will also provide you with a whopping three grams of cholesterol-lowering fiber (e.g., beta-glucan).

2. Become a part-time vegan

Mark Bittman struck a chord in the American mindset with his wildly popular book (http://markbittman.com/book/the-vb6-cookbook/). The diet basically promotes going vegan until dinner, then eating whatever you want. The appeal? No calorie counting and no banned foods; have your steak and eat it, too! Many people love the idea of going vegan (no animal products whatsoever) for better health and weight control but simply can’t fathom cutting out their favorite foods (meat). This part-time concept is sure to remain in vogue in 2014.

3. Try Dark Chocolate

Cocoa, used throughout history as a folk medicine, is now known to have significant health benefits and will surely continue its surge in popularity in 2014. The health benefits in dark chocolate come from the polyphenolic flavonoids in cocoa — flavonoids are antioxidants that are commonly found in fruits, vegetables, tea, wine, and coffee. Flavonoid-rich cocoa (translation: dark chocolate not processed with alkali) consumption is linked to reductions in risk for diabetes, heart attack, stroke and Alzheimer’s. One caveat: Eat your cocoa by the piece and not the bar or by the pound as chocolate is also high in fat, sugar and calories. Typically dark chocolate taste a tad bitter because it is not loaded with sugar and alkali.

See? Three tips for a healthier you!

It is that easy to try some new (ancient) grains and eat them daily, eat less meat and more vegetables and of course, every now and then, have some dark chocolate. These three tips and tricks can help with heart and overall body health.

For more daily health enhancing tips and living, please stay plugged into to this blog and follow us on Twitter @Miami_Nutrition


To your health – Douglas Kalman PhD, RD (@dougkalmanphdrd)