The Fat Girl's Guide to Living

Image by Let Ideas Compete

When I mentioned to a friend that this week’s Fat Girl’s Guide would be on dental hygiene, her initial reaction was skepticism — and a little bit of a bristle. “Why is that a topic?” she asked, “I don’t need to brush my teeth differently because I’m fat.”

She’s right, of course. The basics on brushing (twice daily, and after consuming sugary foods) don’t change based on a person’s weight. But many of us (including me!) might be surprised to learn that ongoing studies over the past five years have focused on the relationship between obesity and periodontal disease. Amazingly, something as deceptively simple as healthy gums can influence a woman’s risk for serious conditions such as diabetes and heart disease.

Despite this riveting explanation, my friend’s eyes glazed over as I spoke, until she finally proclaimed that a whole post on dental health would be “boring.” Readers, I’ll grant you that healthy gums may not seem as exiting as finding comfy undies or learning how to flirt, but we keep it real here at FGG, and that means balancing the sexy with the sensible. Right now there are just a few short paragraphs standing between you and a healthier, happier mouth. I think we’re both up for that challenge, don’t you?

Why your dental habits matter

Let’s start with a few basics. Why is the importance of brushing, flossing and visits to the dentist something that’s drilled into our heads from the time we can hold a toothbrush? (Hint: It’s not just about making sure your dragon breath doesn’t kill living creatures.)

We all know how a “morning mouth” feels – the unclean, almost furry feeling on our teeth and gums. My best friend describes this sensation by saying, “My teeth are wearing sweaters.” In language that’s a bit more technical, the “sweatery” feeling is the sticky film of plaque that has accumulated on the teeth. Caused by bacteria present in the mouth, plaque happens to everyone — young or old, fat or thin. If plaque isn’t removed daily, it hardens into yellow- or brown-colored tartar, which is more difficult to remove.

I’m admittedly not a medical expert in the field of – well, anything, really. So in writing this week’s Guide, I enlisted the professional opinion of Dr. Phyllis Cook, DDS, MPH, PA. Dr. Cook owns her own periodontal practice in North Carolina, and her first order of business was defining for me the difference between a dentist and a periodontist: Periodontists complete three years of advanced training beyond dental school, and their focus is primarily in the supporting structures of the teeth, gums and bone. A high number of the procedures she completes are restorative or reconstructive in nature, as she works on a variety of patients with periodontal disease.

What is periodontal disease?

While it may sound complicated, periodontal disease is just the technical term for gum disease (“periodontal” means “around the tooth”). Most people have heard of the mildest form of periodontal disease, gingivitis, which causes red, swollen gums that bleed easily. If gingivitis remains untreated, it can progress into periodontitis — characterized by plaque growing below the gum line, generating toxins that result in a breakdown of the surrounding gum tissue and bone.

Dr. Cook explains how gingivitis can progress to periodontitis: “When bacteria is present in the patient’s gums, the bone structure moves away from the tooth. This causes deeper pockets between the gum and bone, causing the teeth to loosen. The deeper pockets allow more bacteria to gather, escalating the disease even farther if nothing is done to manage it.”

“Periodontal disease is never cured,” she says. “It’s only managed with proper dental hygiene and routine visits for cleanings.” In short: Periodontal disease never fully goes away and can result in your teeth falling out. Two very good reasons to avoid at all costs.

Women face unique risks for periodontal disease

As women of any size, the hormonal fluctuations we experience during our lifetimes (during major life events such as puberty, pregnancy and menopause, or as a result of taking birth control) do more than affect our moods, appetites, complexions, etc. Those same hormones also cause changes in our gum tissue, which can leave us more susceptible to periodontal disease.

“When a patient is pregnant or on birth control , her gum tissues hyper-react to bacteria (plaque). The gums become swollen and bleed easily,” Dr. Cook says. Conversely, “At the more mature phase of a woman’s life, the lack of hormones can also change gum tissue and bone density. ” Since we’ve already learned how vital bone integrity is to healthy bones and teeth, it makes sense that women with lower bone density (because of osteoporosis, for example) might be at higher risk for gum disease.

How diabetes affects periodontal disease

“While being overweight does not cause diabetes, it is a leading contributor,” Dr. Cook says. “If the diabetes or glycemic index is not controlled the body does not defend effectively against the bacterial challenge of periodontal disease. Maintaining your dental health makes managing your diabetes easier.” Similarly, she says, studies have shown that if a person is managing her dental health, positive effects can be seen in the management of her diabetes.”

For overweight women currently working to manage their diabetes, as well as for women with higher risk because of weight and family history, “Good oral hygiene is critical, along with food choices that will control blood sugar levels,” according to Dr. Cook.

Gum disease increases your risk for heart disease

Are you ready for a sobering fact? Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those with a clean bill of dental health. Don’t see the connection? Neither did I.

“The mouth is the gateway to the body,” Dr. Cook says, “and bacteria is present in everyone’s mouth.” Those higher bacteria levels present in patients with periodontal disease mean there’s more bacteria attaching to fatty plaques inside the arteries and contributing to the clogging and blockage of arteries.

While gum disease alone doesn’t cause heart disease, Dr. Cook says, “Chronic inflammation in the body is one more contributor — just like cholesterol.” Knowing that heart disease is a leading cause of death for adult women — and that obesity increases the risk of heart disease — it makes good sense for overweight women not to compound this risk with poor dental hygiene.

Maintaining good dental health isn’t complicated

The good news is that keeping your teeth and gums healthy is far easier than sweating in the gym for hours a day. In fact, like me, you likely already know all the right stuff you should be doing. . . but don’t always accomplish.

There’s no great secret to maintaining good dental health, Dr. Cook says. The key is to create a daily routine that includes smart, healthy food choices and consistent dental hygiene. Brushing your teeth (and tongue) after every meal and flossing daily will help keep your mouth in good shape between professional cleanings. And if you’re the type of person who spends 20 minutes in the toothpaste aisle agonizing over the endless choices and recommendations, you’re stressing too much, Dr. Cook says.

“The type of toothpaste can help if it makes the patient use it more,” she says, “but it is only of benefit while it’s is being used.” The real result doesn’t come from this brand or that brand, but rather from the mechanical removal of the plaque/bacteria accomplished by brushing and flossing.

And if you slack occasionally on brushing after every single meal, be sure you don’t slack on this: “The single most important thing is to have regular cleanings and dental and gum examinations by a dentist and/or periodontist,” Dr. Cook says. These exams serve to evaluate periodontal health, allow feedback on oral hygiene and provide instruction on ways to improve one’s dental hygiene.

“Regular examinations for patients without periodontal disease should happen every six to twelve months.” If periodontal disease has been identified and treated in a patient, the frequency of “recare” (repeat visits for cleanings and check-ups) is specific to the patient and can be as frequent as every two months.

Why diet is important to dental health

“Foods high in sugar both natural sugars and refined sugars should be avoided because they contribute to tooth decay and periodontal disease,” Dr. Cook says. “When we see patients getting cavities these days, it is mostly attributed to non-diet soda or sugary mints on a very frequent basis.”

In addition to sugary drinks and mints, Dr. Cook lists non-sugar-free gum and candy, grapes, raisins (remember: high natural sugar content), and foods with high refined sugar content (like many breads) as ones that should be avoided or enjoyed in moderation. Tooth-friendly foods she’d love to see her patients consume more frequently include vegetables, proteins, milk, unsweetened dairy products, and sugar-free candy and beverages.

With a little bit of planning and a lot of diligence, maintaining good dental health is an attainable goal for almost everyone. And as someone who occasionally plays fast and loose with the notion of brushing after every meal, I’m ready to invest the few minutes a day it will take to help safeguard my long-term health. What about you?

Information from Dr. Phyllis Cook’s web site and The American Academy of Periodontology contributed to this article. For a quick and easy way to assess your own risk of periodontal disease, take the quiz found here.

He wasn’t kidding about ’70s fashion for boys

We’re excited to announce the debut of “It’s a Guy Thing,” featuring our new columnist, Charlie O’Hay. Each month, Charlie will address everything from how guys perceive the feminine form to the weight-related struggles many men face to raising confident daughters. Please give him a warm welcome!

Until I was 10 years old, words like “diet” or “calorie” were rarely if ever heard in our house. Then my dad had a heart attack. At the age of 39. And everything changed. There were strict rules and forbidden foods, plus calorie-wheels, and bookmarked low-cal recipes everywhere. It was the 1970s, so there was no shortage of self-help or health-guru books. And my parents used them, liberally.

I watched as my dad struggled, truly struggled, to drop the weight. After all, he was a man for whom food was his only excess. He worked at a bank, didn’t drink, didn’t gamble, and he and my mom had slept separately since I could remember. Yes, he smoked. But it was the 1970s. Even the cat smoked. But food was his pleasure, his refuge, his sex, his toy, his love.

My dad and I were a lot alike. Looking back at the curled, sepia-toned photos of his teen years, it was easy to see myself in him. I was chubby, what they then called “husky” (a term that still brings a twinge of shame and a sprinkling of rage when I see it in the context of body size). I was also hopelessly un-athletic, owing in part to a severe birth injury to my right arm, suffered when my mom’s obstetrician attempted to deliver me using hot dog tongs. Being both un-athletic and unpopular at school, the focus of pleasure for me was food. The after-school box of Reese’s Peanut Butter cups was something of a standard. Back in the day (mid-1970s), Reese’s Peanut Butter Cups came 24 to a box, 12 to a layer, and separated by a sheet of brown cardboard. Making it to level 2 meant I’d eaten over a dozen. If I stopped halfway through the box, my mom thought I was coming down with the flu.

So while my dad shrank, I grew. And for those of you who may not remember the fashions of the 1970s, it was NOT a good decade to be either a teenager or chubby. Someone decided that loud plaids, corduroy pants, and broad collars were the epitome of beauty. Going to a department store was an exercise in hopelessness. The clerk would grin, and gently nudge me toward the “Husky” section where the loudest plaids and most deeply ridged corduroys awaited. Someone clearly thought that nobody would notice I was fat if they were blinded by an orange and yellow plaid shirt hovering ominously above brown cords.

So somewhere between the pages of Dad’s diet books, the “Husky” department at Wanamaker’s, and the Hall of Shame that was phys-ed class, my body image was forged.  In 1979, my dad had another heart attack and died. That same year, I sprouted and discovered I liked whiskey better than food. In my adult life, despite a bit of middle-aged dough around the middle, I’ve been what some would even call thin. I’ve been blessed to have loved (and been loved by) some exceptional women in my life, each of whom in her own way assured me that the lions and tigers they’ve faced in the arena of body self-image would make my demons look like the Easter Bunny.

I’m honored that Tee and Toni have asked me to write a regular column for TFGGL and hope it will be a long and mutually beneficial relationship.

Charlie O’Hay is a published poet whose work has appeared in over 100 literary magazines, including Gargoyle, The New York Quarterly, and West Branch. He was awarded a fellowship in poetry and literature from the Pennsylvania Council on the Arts in 1995. He currently works as a freelance advertising copywriter and manuscript editor. He is married to Cecily Kellogg of Uppercasewoman.com and they are parents to a dynamic and beautiful daughter.

Do you promise to love, honor and cherish your heart as long as you both shall live?

Two weeks ago I almost fell over dead. The personal trainer that came complimentary for four weeks with my gym membership tightened the cuff around my arm and pumped. He looked at the reading, then at me.

“Have you ever talked to your doctor about your blood pressure?”
“No, I’ve never really had high blood pressure. Why?”

I was nervous.

“Your blood pressure is 174/94. That’s dangerously high.”

That blood must have drained out of my face, because he quickly jotted it down and moved on to the next test. I blindly went through and passed the rest of them, all the while my heart pounding, which wasn’t helping, at the idea that I had developed high blood pressure in the year since I last had it checked. It wasn’t a complete surprise — my mother, father and grandparents all had high blood pressure. My mother and grandmother had developed aneurysms as a result, and two years ago my mother’s aorta dissected because of it. They’re both at high risk for heart attack and stroke, and both now on healthy doses of blood pressure medication.

But I’m only 38, I thought. My diet isn’t terrible. I get some exercise. I live a relatively low-stress life. How did this happen?

As soon as I got home I looked up everything I could find about high blood pressure. I re-learned some things I was already aware of: that genes play a fair role, being overweight certainly can, and high sodium intake doesn’t help. Otherwise it can be a crap shoot. But one thing was universally clear: high blood pressure not only puts us at risk for heart attack and stroke, but it can cause mild cognitive impairment and nerve and organ damage that affect the proper function of both body and brain. Some of that damage, once it happens, can be irreversible.

So I channeled my panic into challenge mode, and took my questions to a few specialists: “What else can women who are already in the process of improving their diet and manage their weight do to help lower their blood pressure through everyday habits?”

Here’s what they had to say:

Erin Palinski - RD, LDN, CDN, CPT
http://www.erinpalinski.com

Stay away from caffeine, and especially energy drinks. Caffeine raises your heart rate, which raises blood pressure.

If you’re stuck behind a desk or counter for several hours a day, jump up for a short burst of walking every hour. It does wonders for circulation and heart health, and naturally brings blood pressure down.

Sodium is one of the biggest culprits for high blood pressure. Substitute pepper for salt, pepper has no sodium. Neither does Tabasco sauce!

Get plenty of magnesium and potassium in your diet from foods like peanuts and other nuts, dark green leafy veggies, sweet potatoes, beans, low-fat yogurts, bananas, apricots, tomatoes, potatoes (the list goes on!). These two super vitamins help control circulation and muscle contraction, regulating blood pressure in the process.

New research suggests that vitamin D may also have a positive impact on blood pressure. Good sources of vitamin D include salmon, tuna, and eggs, as well as some fortified foods like breads and milk.

Elizabeth Lombardo – Ph.D., M.S., P.T
http://www.controlstressforgood.com

Reduce stress! Stress is one of the leading causes of high blood pressure, and some of the ways we “carry” stress – poor breathing habits, sleep deprivation, diet changes – can make it doubly dangerous. Dr. Lombardo recommends:

Belly breathing. When you breathe with your diaphragm, you induce a relaxation response in your body and mind.

Take a mental vacation. Visualize yourself on the beach (or anywhere that is relaxing to you). Notice how you feel, what you smell, hear, taste, think…fill your senses. Feel your mind and body relax.

Give yourself a time out: When you notice yourself starting to feel stressed, excuse yourself for five minutes and go for a walk around the block. Read some joke emails. Write in a gratitude journal. Listen to an uplifting song. Even short breaks will help bring your stress level down so you are better able to cope with what life throws at you.

Take care of your basic needs. Get the sleep, nutrition and exercise your body needs. You’re not too busy to do these things, you’re too important NOT to do them!

Stephanie Trifoglio – MD, FACP
http://www.marylandgeriatricmedicine.com

Sleep it off! One of the most often missed elements of controlling blood pressure is adequate sleep.  Most of us need 7 to 9 hours of sleep each night, but we don’t get it. Overweight women may also have undiagnosed sleep apnea syndrome. Diagnosing and treating that will often correct or help high blood pressure problems without medication.

Why does sleep affect blood pressure and weight loss? The hormone leptin, secreted when we don’t sleep enough, can cause weight gain, so sleeping more can aid in weight reduction which further helps in blood pressure management.

Kristen Burris – L.Ac., M.S.T.O.M.
http://www.americanacu.com

Deep abdominal breath works really well to lower blood pressure.  Lie on your back and imagine filling a balloon in your belly while breathing in through your nose.  Try to breathe in to the count of 7, hold for 4 and out for 6.  Repeat for 5 minutes and check your blood pressure, it should be lower!

Acupuncture is also very effective for lowering blood pressure.  It treats things associated with high blood pressure like losing weight, stress, and poor circulation.  Anticipate a minimum of twelve visits to have a lasting effect on blood pressure.

Tara Coleman – CN

http://www.taracoleman.com

When it comes to blood pressure the single best thing that you can do is increase your fiber.  I find that the easiest way to accomplish this is to start each day with a high fiber breakfast.  A cup of either Kashi GoLean or Nature’s Path Optimum Slim contain about 1/3 of your optimal amount of fiber (~30g to help lower blood pressure).

An alternative would be to add some fiber to your favorite brand.  An easy and delicious way to do this is to sprinkle some ground flax seeds on top of your morning cereal.  This can also be done with yogurt and salads to kick up fiber and bring down your blood pressure.

——————————————–

A note from Tee: Since that blood pressure check at the club, I’ve learned that my true BP runs about 130/80. What I experienced that day was a situational spike based on a number of factors, including rushing to the appointment, running up two flights of stairs, and being a little nervous about the assessment. This is also known as “white coat” blood pressure. I’m relieved that my daily BP isn’t that high after all, but I’m also glad I had the scare, because it’s made me so much more aware of the effects choices I make have on my overall health.

When your hereditary risk is high for high blood pressure, lifestyle and diet adjustments now, before it becomes a problem, can mean the difference between a long, healthy life and premature illness and even death. So like everything else in life, don’t wait until things start to go south to show your heart some love.