Ask The Experts: Hot Flashes; Pilates for Seniors; Eggs for Breakfast

Q. I’m postmenopausal but still suffering from hot flashes. A friend recommended I take a black cohosh supplement—what do you think?

A. Hot flashes occur when estrogen levels decline after menopause. While they’re harmless, they can be uncomfortable, and for some women they can persist for up to a decade after menopause. After studies linked the use of hormone replacement therapy (previously frequently prescribed to women suffering severe menopausal symptoms) with an increased risk for breast cancer and other serious complications, more women started investigating “natural” ways to ease their symptoms. However, I don’t recommend that people use herbal supplements because they aren’t regulated by the Food and Drug Administration, and can interact with many conventional medications.

There are some studies showing that keeping your core body temperature cool and getting regular exercise may help with hot flashes. Other research suggests avoiding tobacco, alcohol, caffeine, and spicy foods. Drinking cold beverages, eating smaller meals, wearing “breathable” clothing (loose-fitting cotton, for example), and eating a low-fat, high-fiber diet are other “natural” strategies that may work better when it comes to easing hot flashes.

Rosanne M. Leipzig, MD, PhD
Geriatric Medicine

Q. Is it safe for me to start doing Pilates at the age of 75? A friend tells me it might relieve my back problems.

A. Pilates, which is similar to yoga but focuses more on the core abdominal and back muscles, is a good exercise option for seniors. It builds core stability that can help ease lower back pain, and leg strength that may help prevent falls. It also incorporates range-of-motion exercises that increase flexibility.

Pilates is performed either on a mat using your body’s own resistance, or with specialized equipment (if you find lying down difficult, your instructor should be able to show you Pilates movements you can do while sitting in a chair). Your local YMCA or senior center will likely offer Pilates classes tailored specifically to older adults—take classes in preference to buying a DVD to use at home, as the moves are very specific, and not all are safe for people with osteoporosis. A qualified Pilates instructor can ensure you’re doing moves that are safe for you, and doing them properly.

David Thomas, MD, PhD 
Physical Medicine and Rehabilitation

Q. I often eat an egg for breakfast, but I keep being told they aren’t healthy. Is this true?

A. At one time, people used to be advised to limit their consumption of eggs because the yolks are high in cholesterol, and high cholesterol levels are associated with cardiovascular disease, heart attack, and stroke. However, recent research suggests that cholesterol in the foods we eat has little effect on blood cholesterol levels. This means you should certainly be safe continuing with your morning egg—and you’ll benefit nutritionally from doing so, since eggs are packed with vital nutrients, and also are a good source of protein.

Eggs contain small amounts of many B vitamins, but are most notable for choline, a nutrient that is crucial for brain and nerve function. Most Americans come up short of the adequate daily intake of 425 milligrams (mg) for women, and 550 mg for men. One large egg has about 125 mg of choline. Eggs also contain selenium, which plays a role in thyroid hormone metabolism and may help prevent cancer; and iodine, a key component of two thyroid hormones that are involved in regulating metabolism. Egg yolks are a source of vitamin D, and the carotenoids lutein and zeaxanthin: both are antioxidants that may help to protect against age-related eye conditions that can impair your vision, such as cataracts, and macular degeneration.

Keep in mind that the healthiest way to prepare your morning egg is by hard-boiling, poaching, or scrambling it (if you’re having scrambled eggs, add some mixed frozen vegetables or spinach). Always ensure that egg yolks are cooked thoroughly to reduce the risk of foodborne illness (avoid soft-boiled eggs and runny scrambled eggs unless you use pasteurized eggs to prepare them).

Fran C. Grossman, RD, MS, CDE, CDN 
Nutrition

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