New Study Strengthens the Case that LDL Causes Heart Disease

There is little remaining doubt in the scientific/medical community that high levels of LDL, so-called "bad cholesterol", cause heart disease.  Yet in some alternative health circles, the debate continues.  A new study adds substantially to the evidence that LDL plays a causal role in heart disease.

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How Transgender Surgery And Hormones Affect The Body

Bruce Jenner joins a number of transgender celebs who have been outspoken about their experiences. From left to right: Chaz Bono, Ian Harvie, Laverne Cox, Andreja Pejic, Bruce Jenner, Jeffrey Tambor (who portrays a transgender woman on the Amazon show “Transparent”), Alexis Arquette, and Jazz Jennings. (Photo: Getty Images; Everett Collection; Graphic by Jared Harrell for Yahoo Health) 

Gender confirmation, the preferred term among the transgender community for
what is also known as “gender reassignment” or a “sex change,” is the process of transitioning from one gender to another.
Gender confirmation is typically a preferred treatment when someone has gender dysphoria, a condition where there is a conflict between a person’s physical gender and the gender with which they identify.

But the formal gender confirmation process doesn’t happen overnight. According to guidelines set by the World Professional Association for Transgender Health (WPATH), patients undergo several months of psychological therapy and may also utilize hormone therapy to block the sex hormones naturally produced by their bodies and introduce new hormones of their preferred gender. Once they have undergone the required amount of therapy and their doctor has decided they meet the right requirements, they’re able to get a note that they can take to a surgeon to perform gender confirmation surgery. Patients may then go through a number of surgeries on their face, body, and genitalia to reflect outside how they feel inside.

Not everyone goes through the entire process, explainsThomas Satterwhite, MD, a San Francisco-area plastic surgeon who specializes in gender confirmation surgery. While most who elect to do the surgery are taking hormones, some will just undergo hormone therapy and never have surgery.

Bruce Jenner addressed rumors about his transition from male to female. (Photo: Daniel Robertson/Startracksphoto) 

According to experts, gender confirmation surgery, hormone therapy, and counseling have seen recent spikes in popularity after insurance companies started covering these under the Affordable Care Act. “We’ve been extremely busy,” says Satterwhite, whose practice has a six-month-long wait list. Psychiatrist Alex Keuroghlian, MD, a clinical fellow in psychiatry at Massachusetts General Hospital who works with patients who are transgender, has noticed the same thing — he says his practice now sees 35 new patients a month, on average. 

But between constant hormone therapy and multiple surgeries, what effects does gender confirmation have on overall health? Here’s a closer look at some of the top surgeries for transgender men and women:

Cross-Sex Hormone Therapy

Research on the long-term health impact of cross-sex hormone therapy is ongoing, but studies conducted so far have had mixed results.

Research published in the Journal of Clinical Endocrinology and Metabolism concluded that the hormone therapy is “acceptably safe” over the short- and medium-term. But a recent study published in the European Journal of Endocrinology found that male-to-female transgender people had a 51 percent higher early death rate than the general population, mostly due to suicide, AIDS, cardiovascular disease, and drug abuse. Lung and hematological cancer mortality rates also increased. However, researchers found that female-to-male transgender people had no difference in mortality compared with the general population, (they did not indicate why this was the case).

It’s also not yet known whether a man transitioning to a woman would take on the typical health risks of a woman, like an increased risk of developing Alzheimer’s disease, says Satterwhite. But he’s doubtful that would be the case for most patients. “Someone who started the process of taking hormone blockers early, that might be beneficial,” he says. “But I have some patients who come to me who are in their 50s, 60s, and 70s, whose bodies have been doused with testosterone their entire life. I don’t think that would have an impact.” 

Related: Transgender Parents Speak Out About What Makes a Family

Facial Surgeries

Transgender patients may choose to undergo a number of surgeries depending on the gender they want to be, says John Martin, MD, a board-certified facial plastic surgeon in Miami who specializes in the facial feminization of transgender patients. He performs brow lifts, facelifts, and eyelid surgeries, and also adds fillers to the cheeks.

Martin says his patients don’t need to space procedures out for health reasons since they’re typically done with local sedation, but many people do for financial reasons. Most procedures have up to two weeks of bruising, but it can take up to three months for all of the swelling to go down.

“There are not many health risks with these facial surgeries,” he says.

Vaginoplasty

This involves the use of one of several techniques to create a vaginal canal and vulvo-vaginal structure for patients transitioning from a man to a woman. Satterwhite typically performs the penile inversion vaginoplasty, which takes skin from the penile shaft and uses it to create a vaginal canal. The process can take five to six hours to complete. “It’s a complicated operation,” he says.

Risks include bleeding and the need for a blood transfusion, damage to nearby organs (the urethra, bladder, and rectum), and potential loss of sensation in the area. “My goal is to create a vagina that has erogenous sensation,” Satterwhite says. “There is a potential risk of losing that sensation, but I haven’t seen it happen on a permanent basis.”

The new vagina is at risk of collapsing on itself, so transgender women need to use dilators regularly — more often at first and then less frequently over time.

Patients also run the risk of developing a fistula, an unnatural connection between the vagina and other organs. When that happens, feces and urine can travel into the vagina and leak out of the vaginal opening. “It’s a rare thing, but I warn my patients,” says Satterwhite. 

Breast Augmentation

Breast augmentations are one of the top procedures Satterwhite performs on transgender women. People who undergo it are at risk for capsular contracture, where scarring develops around the implant, and, less frequently, a ruptured implant.

Related: Saying Goodbye To ‘Mr.’ And 'Ms.’ And Hello To 'They’

Mastectomy

This surgical operation removes the breasts for women transitioning to men and involves removing the nipple and areola as skin grafts, making them smaller, and repositioning them higher on the chest. While Satterwhite has never seen it happen in his own practice, he says it’s possible that the skin graft can be rejected by the body, die, and then fall off. (Smokers are at a higher risk of developing this condition.)

Patients who undergo a mastectomy are also at risk for developing a hematoma (a collection of blood) or seroma (a fluid collection) in the breast area — which could lead to infection or the fluid being absorbed back into the body.

Metoidioplasty

Metoidioplasty is a procedure that creates a penis by extending the clitoris that has been enlarged by testosterone hormones. It’s an outpatient surgery and has a short recovery time, says Satterwhite.

However, the penis created by metoidioplasty is typically very short (on average four to six centimeters), and patients can sometimes have difficulty urinating hygienically.

Phalloplasty

Phalloplasty constructs a penis using skin from the inner forearm and vaginal tissue, which is then attached to the vaginal area. While it creates a more realistic-looking penis, Satterwhite notes that it’s a technically difficult operation with a long recovery time (patients are in the hospital for five days and off from work for up to a month).

Phalloplasty patients also have a higher risk of complications like hardening of the urinary tract and tissue death in the new penis. They may also have scars on their arms or leg where the skin was taken from, which can be a giveaway that someone has had the operation. 

Physical Vs. Mental Harms — And Benefits

Of course, there are risks associated with any type of surgery and hormone therapy. But how does the overall risk stack up against the potential psychological damage of being trapped in the wrong body?

 According to Keuroghlian, people with gender dysphoria can be “highly distressed” (before gender confirmation), and may suffer from depression and anxiety. They’re also at a high risk of developing a substance abuse disorder. But “these symptoms routinely improve once patients are fully able to express their gender identity to the world,” he says.

Satterwhite says his patients improve on many levels post-confirmation — psychologically, emotionally, physically, and spiritually. And overall, Keuroghlian says the benefits “strongly outweigh” any possible risks, adding that people are thrilled with the outcome: “I have not yet encountered a patient who has regretted transitioning if the process was pursued thoughtfully.”

Eat This, Not That, For Amazing Abs

Get swimsuit-worthy ripples by summer with these 8 slimming swaps. (Photo: Shutterstock)

Here are four proven and effective ways to get abs fast:

• Go on a crazy restrictive vegan cleanse—the method preferred by Beyonce.
• Do 600 sit-ups a day—a la former Spice Girl Mel B.
• Live on nothing but protein shakes—like Victoria’s Secret model Adriana Lima.

Or

• Make 8 simple swaps, eat steak and potatoes, and sacrifice nothing—and lose up to 16 pounds in 14 days.

Sure, the 600 sit-ups sounds tempting. (Hey, that’s only 18,000 a month.
Come on!) But at Eat This, Not That!, we’re all about getting the hot, sexy belly you want while eating the hot, sexy foods you want—and not spending half an hour each day doubled over in physical agony.
So we identified some easy swaps that will turbocharge your metabolism, tame your hunger and set your body’s belly-burning mechanisms to automatic—inspired by The Abs Diet creator David Zinczenko’s new book, Zero Belly Diet. Get ready to reveal the lean, firm belly you desire–coming soon to a pool party near you!

Eat This for Abs!

Whole Eggs

(1 large) Calories 78, Total Fat 5.3 g, Saturated Fat 1.6 g, Sodium 62 mg, Carbs 0.56 g, Fiber 0 g, Sugar 0.56 g, Protein 6.29 g

Not That!

Egg Whites

(1 large) Calories 17, Total Fat <0.1 g, Saturated Fat 0 g, Sodium 55 mg, Carbs  0.2 g, Fiber 0 g, Sugar 0.2 g, Protein 3.6 g

Put down the calculators, calorie counters! Yes, you get 61 more calories from a whole egg, but calories aren’t the only important thing when it comes to weight loss. The magic of the yolk comes from a B vitamin called choline, which acts directly on the genes that cause fat storage in the abdomen. (One reason heavy drinkers have bloated bellies is that alcohol depletes choline, causing weight gain around the liver.) Plus, the yolk is also loaded with heart-healthy vitamin D. If the thought of eating whole eggs still makes you uneasy, make a scramble with one whole egg, and two or three egg whites. And lose three inches from your waist using this essential list of The 9 Best Flat-Belly Superfoods.

Eat This for Abs!

Baked Potato

(1 medium potato with skin) Calories 115, Total Fat 0.06 g, Saturated Fat 0g, Sodium 12 mg, Carbs 26.71 g, Fiber 4.6 g, Sugar 0.81 g, Protein 2.49 g

Not That!

French Fries

(1 cup) Calories 182, Total Fat 9.7 g, Saturated Fat 2.2 g, Sodium 110 mg, Carbs 21 g, Fiber 2 g, Sugar 0.39 g Protein 2.14 g

Thanks to the popularity of low-carb diets, white potatoes have been unfairly blacklisted. But spuds are studs when it comes to keeping you full—even more satiating than traditional healthy eats like brown rice and oatmeal, an Australian study found. The more satisfied you feel, the less apt you are to graze throughout the day and take in excess calories. But not all varieties of potatoes are created equal. A baked potato with its nutrient-filled skin is much different from the caloric clown car known as a French fry. In fact, one study found that French fries ranked among the top foods most associated with problematic, addictive-like eating behaviors—their lethal balance of salt and fat means eating just a few is nearly impossible. Eat more old favorites—and lose belly fat while doing it—with this list of 6 “Unhealthy” Foods That Actually Help You Slim Down

Eat This for Abs!

Oatmeal

(1 cup, prepared with water) Calories 159, Total Fat 3 g, Saturated Fat 0.5 g, Sodium 115 mg, Carbs 27 g, Fiber 4 g, Sugar 1 g, Protein 5.55 g

Not That!

Quaker Cinnamon Oatmeal Squares

(1 cup) Calories 210, Total Fat 2.5g, Saturated Fat 0.5g, Sodium 190 mg, Carbs 44 g, Fiber 5 g, Sugar 9 g, Protein 6g

The word “oatmeal” is not synonymous with the word healthy—as the existence of the oatmeal cookie proves. To prove this point, researchers divided study participants into two groups: One group was given a 363-calorie breakfast of oatmeal, while the second group was served a ready-to-eat oat-based cereal like Quaker’s Squares, with the same number of calories. When asked to rate their appetite after eating, the oatmeal-eating participants said they were significantly less hungry than their cereal-eating counterparts—even four hours after breakfast! The bottom line: Real oatmeal—the stuff you cook on the stovetop—will melt away pounds far more efficiently than any oatmeal-affiliated foodstuff can.

Eat This for Abs!

Pink Lady Apples

(1 medium) Calories 72, Total Fat 0.23 g, Saturated Fat 0 g, Sodium 1 mg, Carbs 19, Fiber 3.3 g, Sugar 14.34 g Protein 0.36g

Not That!

Mott’s Apple Juice

(8 fluid oz) Calories 120, Total Fat 0 g, Saturated Fat 0 g, Sodium 10 mg, Carb 29 g, Fiber 0 g, Sugars 28 g, Protein 0 g

How would you like to drink a glass of 42 melted M&Ms? Apple juice is one of the most sugar-laden of all juices, and most of its sweetness comes from fructose, a type of sugar associated with the development of belly fat. 

Straight-from-the-tree apples, on the other hand, are one of the best fruit-sources of fiber, a nutrient proven to be integral to reducing belly fat. In fact, for every 10-gram increase in soluble fiber eaten per day, visceral fat was reduced by 3.7 percent over five years, a recent study found. Bonus: Of all varieties, Pink Lady apples are ranked highest in antioxidant flavonoids, which can help protect against cardiovascular disease. Learn more simple tricks in the most-shared Zero Belly: 14 Ways to Lose Your Belly in 14 Days!

Eat This for Abs!

Sirloin Tip Side Steak

(6 oz) Calories 296, Total Fat 9.6 g, Saturated Fat 3.6 g, Sodium 94 mg, Carbs 0 g, Fiber 0 g, Sugar 0 g, Protein 48 g 

Not That!

Rib Eye Steak

(6 oz) Calories 326, Total Fat 14.4 g, Saturated Fat 6 g, Sodium 100 mg, Carbs 0 g, Fiber 0 g, Sugar 0 g, Protein 50 g

Here’s the rule of meat: protein good, saturated fat bad. Protein builds muscle and revs your metabolism, helping to melt away belly fat and reveal your abs. Saturated fat, on the other hand, does the opposite: In a 2014 study in the journalDiabetes, researchers found that people who ate foods higher in saturated fat gained primarily abdominal fat—twice as much as those who ate the same amount of calories from foods containing unsaturated fats. The reason: according to the study authors, genes involved in regulating metabolism, insulin resistance, body composition and fat cell differentiation behaved differently in test subjects depending on the kind of fat they ate. For the abs-building protein without the belly-building sat fat, look for lean proteins like sirloin or top loin steak, poultry or fish.

Eat This for Abs!

Grey Poupon Classic Dijon Mustard

(1 tablespoon) Calories 15 Total Fat 0g, Saturated Fat 0 g, Sodium 360 mg, Carbs 0 g, Fiber 0 g, Sugar 0 g, Protein 0g

Not That!

Ketchup

(1 tablespoon) Calories 20, Total Fat 0g, Saturated Fat 0 g, Sodium 160 mg, Carbs. 5 g, Fiber 0 g, Sugars 4 g Protein 0 g

Eating just 1 teaspoon of low-cal mustard can increase your metabolism by up to 25 percent for several hours, according to researchers at England’s Oxford Polytechnic Institute. Ketchup on the other hand, is a calorie and sugar trap. “Just one measly tablespoon has up to four grams of sugar and 20 calories—which might not seem like a lot—but the average consumer will douse their food with at least four or five,” explains Lisa Moskovitz, R.D., founder of The NY Nutrition Group. “Plus, it’s loaded with high fructose corn syrup, which has been shown to increase appetite and, over time, lead to health problems such as obesity and diabetes.” Yikes! Are beware: You may be eating the 11 Foods Diet Experts Won’t Touch—click to be sure.

Eat This for Abs!

Lifeway Veggie Kefir: Beet Flavor

(1 cup) Calories 110, Total Fat 2.5g, Saturated Fat 1.5g, Sodium 120 mg, Carbs 12 g, Fiber 10 g, Sugars 15 g, Protein 10 g

Not That!

FAGE Total 0% with Honey

(5.3 oz) Calories 170, Total Fat 0g, Saturated Fat 0g, Sodium 65 mg, Carbs 8g, Fiber 0g, Sugars 29g, Protein 13g

Greek yogurt is one of the best belly-flattening foods out there, but be wary of the fat-free versions. To make up for a lack of fat, even the best brands wind up with added sugar—in this case, more than a Snickers’ Bar worth of the sweet stuff. And if you’re at all lactose intolerant, the bloating caused by yogurt will only succeed in making your belly rounded, not ripped.  If you’re finding this out a little too late, drinking kefir can help reduce some of the damage. Sipping the beverage can reduce bloating and gas brought on by lactose consumption by 70 percent, according to Ohio State University researchers! We like Lifeway’s Veggie Kefir line because each bottle has 110 calories, only 15 grams of sugar (which is low in the flavored kefir world), and a full serving of veggies. Kefir’s stomach-flattening effect is why it ranks among our 12 Foods That Will Make You Look Better Naked.

Eat This for Abs!

Spinach

(1 cup) Calories 7, Total Fat 0.12 g, Saturated Fat 0 g, Sodium 24 mg, Carbs 1 g, Fiber 0.7 g, Sugar 0.13 g, Protein 0.86 g

Not That!

Kale

(1 cup, chopped) Calories 33, Total Fat 0.6 g, Saturated Fat 0.1 g, Sodium 25 mg, Carbs 6 g, Fiber 2.4 g, Sugar 1.52 g, Protein 2.9 g

Rich in muscle-building protein, satiating fiber and vitamins A, C and K, kale is one of the trendiest—and healthiest—veggies out there. Even so, the dark, leafy green does have one notable downside: it’s loaded with a sugar called raffinose that remains undigested until bacteria in the gut ferments it. Once this process begins, the stomach produces a gas, that makes you bloat and covers up your hard-earned abs. But don’t shun all the greens in the produce aisle just yet. Spinach is one green that you’ll want to reach for. It’s not only filled with water (which can help keep you full), but also contains powerful appetite-suppressing compounds called thylakoids. Basically, this low-cal veggie can help you fill up without filling out. Add some to a breakfast smoothie, morning omelet, lunchtime sandwich or use it to make a dinner salad in lieu of your go-to greens.

Do Slower-digesting Carbohydrates Make Us Feel More Full?

One of the most common pieces of advice in the health-nutrition world is that we should focus our carbohydrate intake on slowly-digesting carbohydrates, because they make us feel more full than rapidly-digesting carbohydrates.  Rapidly-digesting carbohydrates, such as potatoes, stand accused of causing us to overeat, resulting in obesity, diabetes, and many other chronic ailments.  Is this true?
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Food Reward Friday

This week's "lucky" winner... bacon fried Oreos!!

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My Buddy and Me

Warning -- Satire -- April Fools Post

I have a sheepish confession to make: until recently, I had a tapeworm, and that's why I'm lean.

In 2006, I took a trip to Mexico with a few friends.  We often traveled through rural areas, and of course sampled the local cuisine wherever we went.  In many parts of Mexico, pork is an important food.  Some of it may have been a bit undercooked.

At the time, my interest in food and health was growing, and I was making many changes to my diet.  I was glad to see the chubbiness around my neck and waist begin to disappear.  The diet was working!  Or so I thought...

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