Our nutritionist/guest blogger Victoria Shanta Retelny, RD, LDN, knows that Valentine’s Day is around the corner, and for many of us, that means one thing: chocolate. Vicki shares how we can indulge in our favorite treat and still maintain our health, and waistlines. Try her recipe below for a quick and easy chocolate fix. 

By Victoria Shanta Retelny, RD, LDN

What would Valentine’s Day be without chocolate? I say, the darker the better – at least 60% cocoa, that is. Not only is dark chocolate soothing for your taste buds, but your heart reaps the rewards – and for American Heart Month, that’s good news, too.

Cocoa actually has worn a badge of honor for centuries. Early meso-American cultures viewed it as “magical” with uses ranging from medicine to currency. As many as 350 years ago, Europeans believed that chocolate (or the beverage cocoa) was good for the liver, heart and digestive tract, as well as created a sense of happiness and strength (Journal of the American Dietetic Association). In the United States, however, this belief was slower to catch on — only in the last couple of decades has chocolate’s nutritional value received attention by the medical community.

Numerous studies have found a daily dose of dark chocolate to be beneficial for your cardiovascular system. A study in the British Medical Journal (2012) of 2,013 people with metabolic syndrome (ie, large waistline or “apple shaped,” high triglycerides, and/or insulin resistance) who ate dark chocolate every day showed marked improvement in blood pressure levels and cholesterol levels. It’s important to note – that an ounce of dark chocolate – about 100 grams of polyphenols (the powerful chemicals in cocoa) is a healthy dose. Like anything, don’t overdo it – as your waistline might feel some negative effects.

Dark Chocolate Fruit Cuties

This recipe is delicious with your favorite fruit.

Serves 2

Ingredients:

1 cup apples, sliced
1 cup strawberries, halved
12 oz. semi-sweet or dark chocolate chips
Unsweetened cocoa powder for dusting

1. Heat chocolate in the microwave for 30 seconds on high. Stir and repeat until melted.

2. Dip the fruit in the chocolate – half or three quarters of the way. Place on wax paper to cool. Dust with cocoa powder and serve.

Recipe courtesy of The Essential Guide to Healthy Healing Foods by Victoria Shanta Retelny, RD.

Dr. Laurie Steelsmith, a licensed naturopathic physician, acupuncturist and nutrition expert in Honolulu (no wonder she’s happy), shares her thoughts about how dark chocolate – dark chocolate – affects our moods, energy and sexual function.

Here are just a few ways:

1. Increases blood flow to sexual organs.

Chocolate contains L-arginine, an amino acid that can be an effective natural sex-enhancer for both women and men. It works by increasing nitric oxide and promoting blood flow to the sexual organs, which increases sensation, satisfaction and desire.

2. Stimulates and elevates mood.

Chocolate is known as a super libido food partly because it is a rich source of PEA, the acronym for phenylethylamine, sometimes referred to as the “love supplement” or the “romance chemical.” As a stimulant and mood elevator, PEA can induce sensations of euphoria – and it’s naturally released by our brain when we’re in love! This chemical promotes the production of the neurotransmitter dopamine, which enhances feelings of well-being, joy and pleasure.

3. Acts as an energy booster.

Chocolate packs an aphrodisiac punch because it also contains the compound theobromine, found in tea and kola nuts as well. This substance works on the central nervous system, causing one to feel stimulated and excited.

There’s no doubt about it. Eating chocolate can be a sensual experience, but it’s also good for our health. The right type of chocolate can be loaded with immune-boosting antioxidants, making it very beneficial for the heart. If we’re going to indulge in chocolate regularly, however, dark chocolate is best – as pure and unsweetened as possible. The extra fat and calories in other chocolate products can end up having poor health consequences and anti-aphrodisiac effects.

And we don’t want that.

* * * * *

Dr. Laurie Steelsmith is a licensed naturopathic physician, acupuncturist, and nutrition expert with a 20-year private practice in Honolulu. A leading spokesperson on natural medicine, she has appeared widely on TV, radio, and in print. She and her husband, Alex Steelsmith, are coauthors of Great Sex, Naturally: Every Woman’s Guide to Enhancing Her Sexuality Through the Secrets of Natural Medicine (Hay House, 2012) and her previous bestseller, Natural Choices for Women’s Health (Three Rivers Press). Learn more at www.drlauriesteelsmith.com.

Northbrook’s Village Green in January.

It’s an odd winter in Chicago, with temps nearing 60 and rain but THERE’S STILL THAT GRAY SKY. No leaves on the trees, no snow on the ground, just a bunch of dismantled holiday lights and Christmas trees thrown to the curb. So many people are experiencing winter-inspired depression, lack of motivation and all-around foul moods.

Short of moving to a sunnier climate, or buying a light box for the treatment of seasonal affective disorder (SAD), is there anything we can do to brighten things up? Well, it appears so.

Research has shown how color therapy, known as chromotherapy, is a natural way to counteract negative moods. Both babies with jaundice and people with SAD are treated with color therapy.

To combat the blues and bring some color into your life, try the following:

• WEAR COLORFUL CLOTHES AND UNDERGARMENTS – Clothing that’s bright will instantly put you in a cheerful mood and even make others around you feel merry as they visually absorb your brightness.

• PAINT YOUR HOME OR OFFICE – Painting walls a certain color will instill a particular mood for that room: vibrant colors, such as yellows or oranges, will fill a room with excitement and warmth; dark colors, like grays or browns, create a boring, monotonous feeling; and pastel colors, such as lavender and pinks, infuse calm feelings.

• ACCESSORIZE – If changing the wall color is inconvenient, spice a room up with fun-colored pillows, rugs, window treatments, art pieces or plants.

• GET NEW LIGHT BULBS – Light bulbs with full spectrum lighting mimic natural sunlight to emit all colors of the rainbow and reduce depression.

• BE COLORFUL WITH FOOD – Eat and smell foods, oils and spices that are yellow, orange, green and red. Not only do these colors give feelings of joy, tranquility and passion, but they have rewarding health benefits, too.

• WEAR COLOR THERAPY GLASSES – Lenses with colored tints allow for light entering your body to be concentrated in one spectrum. Therefore, your mood will enhance according to the color of your lenses.

• VISUALIZE COLORS IN MEDITATION – Imagining yourself surrounded by a specific color will help instill the mood associated with that color.

• CONSIDER A COLOR THERAPIST – Color therapists can determine the most enlightening color for your mood by providing supervised color therapy treatments under special colored lights. For example, the Enlightened Healing Center in Orland Park, IL uses red and infrared light therapy to treat inflammation and stimulate new, healthy cell growth.

With thanks to Karen Erickson of Chicago Healers, the nation’s pioneer prescreened and integrative health care network, offering a comprehensive understanding of each practitioner’s services, approach and philosophy. Its holistic health experts teach and advocate natural and empowered health and life choices through their practices, the media, educational events and website. For more information, visit www.ChicagoHealers.com.

I was compensated for my participation in Coca-Cola’s Balanced Living Workshop, but my thoughts and views are my own.

Working out with Harley Pasternak. Coca-Cola and Bruce Powell Photography.

Wake-up call. That’s how I would sum up my two-day Coca-Cola Balanced Living Workshop in Chicago last week. I can’t say enough about the top-notch staff – registered dietitians and fitness trainers — as well as the 23 other Chicago-area mommy bloggers in attendance. While there were many memorable moments, I’ll spare you the details and give you the highlights.

My personal favorite was working out with Harley Pasternak, the celebrity diet and fitness coach (he trains Jessica Simpson, Lady Gaga, Katy Perry, Megan Fox). I got up front and center so we could sweat side by side. This man, who flew in and out of Los Angeles the same day so he could be there, was amazing.

He really seems to get the female body psyche.  He described the average “fit” person:  seated at a computer all day, drive to the gym, workout for 45 minutes, grab a low-fat muffin and freshly squeezed juice on the way out, and go home to dinner. Splurge on dessert because you just worked out. Burn off 400 calories and consume 750. Shame on us. We’ve got it all wrong.

Harley offered these tips:

Stay active throughout the day, not just during your workout. I tried to tell Los Angeles-based Harley that it’s difficult to move much on the coldest days in Chicago, but he didn’t buy it. We can still take a walk outside after dinner or, on those especially heinously cold days, go walk at the mall. Harley answers voice mails during his walks.

Stand up when you can. If you’re really computer-bound, think about investing in a stand-up workstation. They’re becoming more popular and affordable. Never sit at your computer/desk for longer than an hour without getting up and walking around. And NOT to the kitchen to get a snack.

Do resistance training. Apparently all that cardio I do isn’t enough to stave off mid-life weight gain. I need to burn calories all day long, and that takes resistance training. Resistance builds muscle which burns calories throughout the day; not just during a workout. You don’t have to go to the gym. Harley demonstrated some simple exercises anyone can do at home. And, you don’t need expensive gym shoes. You need the right shoes for the exercise, but spending a lot isn’t necessary. I tried Harley’s Hollywood Workout and loved how it tracked the calories I burned and how well I performed each exercise.

Also, I can stop doing those damn abdominal crunches. All they do is strain my neck and create a round-shouldered appearance. Harley says to do a reverse fly to strengthen and tone the muscles in the upper back between the shoulder blades. It makes our posture better and draws in the abs. Stand with feet a foot apart, bend forward at a 90 degree angle with knees slightly bent, back arched, arms straight and outstretched to the sides while squeezing your shoulder blades together. He had us do 30 reps and I could definitely feel it the next day.

I also met with a registered dietitian. Thank you, Christine Palumbo, RD. I’ve already started making changes.

Have the right snacks on hand. That witching hour when I do all my dietary damage is 3-5pm. There’s such a big gap between breakfast and lunch and then lunch and dinner. I didn’t know that our serotonin drops around 3 p.m. each day. We need a snack high in protein.

Some ideas:

* A handful of almonds or walnuts.  I just bought the 100-calorie packs of Emerald Natural Walnuts and Almonds.

* Peanut butter on Triscuit or Ry Krisp crackers.

* Greek yogurt with fresh fruit.

* Carrots with hummus.

Other takeaways:

* It’s about total diet, not just about any one food.

* Fill your plate with one half vegetables/fruits.

* Bake with unsweetened applesauce rather than oil.

* Choose breakfast cereal with at least 3g fiber and low in sodium.

* Choose loin or round cuts of meat.

* When looking at food labels, try to aim for 5% or less (percent daily value) in total fat, saturated fat, cholesterol and sodium. Aim for 20% or higher in vitamins, minerals and fiber.

I was surprised to learn just how committed Coca-Cola is to community health. They’ve changed the products made available in schools. It’s now easier to find calorie information on their products. And they have so many more choices, like their 90-calorie mini cans. They’re also partnering with the American Academy of Pediatrics (they are a sponsor of healthychildren.org), the American Academy of Family Physicians (sponsor FamilyDoctor.org), and the American College of Sports Medicine.

Some novel ideas:

* Use cookie cutters to cut out cute holiday shapes in a tortilla and bake at 350 degrees for 3-5 minutes.

* Use salsa as a salad dressing.

* Bake a potato and serve with low-fat melted cheese and black beans.

Enough talk. It’s time for my workout. Let’s keep each other posted on our progress. If you try any of these fitness or diet ideas, let me know how they work for you!

But, not so fast, fellow hypochondriacs. It doesn’t have to be that kind of holiday season. I’ve asked Jude Bijou, MA, MFT, for guidance in how to deal with a mother-in-law trying to take over the kitchen, a sister who always has a better way to do things, an aunt who demands to know the status of your diet (or love life, whichever is worse), or a cousin bragging about her job promotion while you’re still searching. Jude Bijou, MA, MFT, is a psychotherapist, professional educator and workshop leader in Santa Barbara, CA.

Here are six ways to handle people who are rude, critical, controlling, nosy and insensitive.

Tell them you’re not seeking advice.

A good way to stop a bull who’s charging at you with unsolicited advice is to fend them off with a simple statement such as, “Thanks, but I’m not looking for advice right now.” If the person continues, lovingly say it again. And again, if necessary!

Acknowledge their good intention.

Mention that you appreciate the person’s support and concern. If you want, tell the person you might love his or her advice and input later–when you’re ready to ask for it.

Firmly stand your ground.

Sometimes, especially with particularly pushy people, it’s necessary to tell them it’s not helpful for you to receive unsolicited advice. Say it lovingly, but if they persist, tell them that you’re starting to feel angry or frustrated and you’d like them to stop, please. Repeat and repeat some more.

Realize that it’s not about you.

When people feel compelled to tell you what you should do, remember that what they’re saying and what’s unconsciously motivating them has little to do with you. They may need to feel important. They may be looking for love or respect from you or others. The reality is that you are fine. They have unexpressed anger and are targeting it on you. They forget that their domain is themselves and that their job is to find their own happiness. Rather, they believe they are entitled to mosey into someone else’s territory without permission.

Appreciate them when they’re not giving advice.

If you notice that a critical or pushy relative is being empathetic or listening with sensitivity, be sure to give him or her kudos for being so wonderful, caring or attentive. In other words, catch them being good. Praising what you do like may subtly sink in and help to change his or her behavior.

Let out those pent-up emotions.

After a long day of fending off critical, over-controlling relatives who’ve tested the boundaries of your patience and politeness, you need to get all that anger and possibly sadness out of your system. Find a private place to pound your fists, stomp your feet, growl and cry. You’ll feel better instantly, and ready to face them all over again tomorrow for the holiday brunch!

* * * * *

Jude Bijou’s theory of Attitude Reconstruction® evolved over the course of more than 30 years working with clients as a licensed marriage and family therapist, and is the subject of her award-winning book, Attitude Reconstruction: A Blueprint for Building a Better Life. Learn more at http://www.attitudereconstruction.com./

I was compensated for my participation in Coca-Cola’s Balanced Living Workshop, but my thoughts and views are my own.

Woo hoo! I’ve been selected as a Chicago-area mommy blogger to attend the Coca-Cola Balanced Living Workshop next week in downtown Chicago. Imagine – two days filled with one-on-one fitness and nutrition consultations, cooking demos and more – all while dressed in jeans and free from carpools. (Did I mention I’m excited about this?) The goal of the workshop is to find a balanced approach to both personal and family wellness. Just getting there is part of my balancing act.

There couldn’t be a better time to step up my health and wellness routine. December – the month of endless sugary and carb-laden temptations. Gift baskets, peanut brittle, peppermint mocha hot chocolate. Throw in a winter vacation, and I have to bring my Midwestern body out of the closet. It’s enough to make my head spin, and if someone wants to keep me on the straight and narrow, I’m all yours. 

I hope to bring my fellow hypochondriacs some new health and diet findings. I’ll participate in an interactive cooking demonstration with professional chefs. Maybe I’ll bring back some new dinner ideas. I could definitely use some inspiration in the kitchen. I think my dinner repertoire has become rusty. Last week my 13-year-old told me to throw some vegetables into our usual pasta marinara. Voilà, pasta primavera was born in my household. 

I’ll visit a local grocery store with a registered dietitian to brush up on reading labels and selecting the best produce. I know there’s a trick to choosing the healthiest products but seriously, when I see endless store shelves stocked with multiple versions of the same product, my eyes glaze over. Ultimately, I end up reaching for the tried and true. If I could just learn how to swap foods à la Buy This, Not That. 

My goal for the coming year is to cut back on carbs. Incorporate more veggies into my traditional dishes. Substitute cauliflower for starch…that kind of thing. Keep the family happy and in the process start making amends with my metabolism.  We can co-exist peacefully, after all. 

I have another goal. I want a fitness expert to tell me if the time I’m spending at the gym is effective. Maybe I should spend less time on the elliptical and more on strength training. Is it better to work out 30 minutes every day of the week, or 4 days a week for 45 minutes? What activities will help me burn calories even while at rest? Which machines are best?  

I promise to report back on my inspirations/revelations with you. With a little help from this workshop, we can all enter 2013 looking and feeling our best!  

“No one wants to be reminded they can’t have it all, but there is a huge cost to trying to keep up with holiday expectations.” says Jenny Conviser, Psy.D., co-founder of Insight Behavioral Health Centers and a leading Chicago expert in the treatment of mood and anxiety disorders and eating disorders.  “There is a middle ground we can strive to achieve somewhere between giving up holiday fun and giving up ourselves.”

Dr. Conviser offers these tips for a simplified holiday that might just help preserve your health and well-being.

Plan ahead for healthy eating – Fill the crock pot or defrost the casserole before heading out for the mall. Having a healthy dinner waiting at home will help you pass up the fast food stop. Keep healthy snacks readily available. Carry cut up fruit, veggies, nuts and water with you during the day.

Quash the quantities – Don’t allow yourself to be surrounded by large quantities of food if that poses risk for you. After the party, send guests home with extra dessert items or send dinner over to an elderly neighbor.

Keep moving – Bonding time doesn’t always have to involve eating. Share activities with the kids and relatives. Get out of the house and go ice skating, sledding, hiking or just a walk around the block after dinner.

Exercise early – Try to exercise often and early. Don’t try to fool yourself that there will be time later in the day to get in a workout, as that rarely happens. If you get it in early, you will feel better all day. Exercise brings dual benefits of greater desire for healthy foods and improved energy.

Avoid fatigue – Keep sleep a top priority. If your energy level is running on empty, you won’t be able to fully be present for yourself or your family. Also, if you are over-tired, it can be a set up for impatience, irritability and/or overeating.

Keep spending in check – Stick with a more conservative budget that won’t come back to haunt you in the New Year. Organize activities that are easy on your wallet. For example, forego an evening at the movies for game night at home.

Don’t set yourself up for stress – Reserve time and space in your holidays for the two or three traditions you value most. Be willing to let go of less valued traditions. Shop online, shorten gift lists and try to select one gift that works for many people on your list.

“Take a reflective moment to recall what you value most in previous holidays and re-create the moments that feel the most satisfying and rewarding,” says Dr. Conviser. “Keep your health and well-being in mind. Celebrate the season….and celebrate you.”

Insight Behavioral Health Centers provides treatment for mood and anxiety disorders and eating disorders, including anorexia, bulimia, and binge eating. Insight offers a comprehensive program with locations in Northbrook, Evanston, Willowbrook and downtown Chicago. For more information, visit www.insightbhc.com, or call
312-540-9955.

Our nutritionist/guest blogger Victoria Shanta Retelny, RD, LDN, is always looking out for us. With Thanksgiving just a few days away, Vicki shares what we need to know about going gluten-free, and whether it’s the right choice for us.  Try her delicious roasted veggie recipe to dress up your Thanksgiving table AND keep your guests healthy.

By Victoria Shanta Retelny, RD, LDN

Gluten-free is a hot diet trend right now with annual sales of gluten-free products expected to reach approximately $2.6 billion in 2012. It’s enticing to jump on the bandwagon during the holidays with tempting food and drinks everywhere. If you are among the 1 percent of the U.S. population who has been diagnosed with celiac disease or you have diagnosed gluten intolerance, then banishing gluten is the way to go.

Gluten, the protein found in wheat, rye, barley, and related cereals like spelt, khorasan (aka Kamut®), farro, bulgur and possibly oats, can damage the intestinal tract causing poor absorption of nutrients and eventual nutrient deficiencies. If left untreated, celiac disease may lead to gastrointestinal cancers, thus a gluten-free diet is a must.

On the flip side – gluten has health benefits that far surpass the rationale to eliminate it – if it’s not medically necessary. A recent article in the Journal of the Academy of Nutrition and Dietetics (September, 2012) highlighted gluten’s health benefits. There’s no real scientific proof that going gluten-free leads to weight loss; many gluten-free products often contain more calories and additives that gluten-containing ones. Plus, gluten-free products are devoid of whole grains and fiber, two nutritional players that can fill you up more quickly and for longer on fewer calories, which may keep your waistline in check.

In addition, gluten-containing grains like wheat contain a specific type of starch that resists digestion in the small intestine and ferments in the large intestine, which helps fill the gut with healthy bacteria or probiotics. These friendly microorganisms help defend against some cancers, inflammatory conditions and even cardiovascular disease by improving blood lipid levels – all good reasons not to banish gluten-containing grains, if you don’t have to. Just monitor your portions – a half-cup of cooked whole grains equals one serving.

However, if you have to avoid gluten, here are some tasty gluten-free sides for Turkey Day:

• Cornbread stuffing with walnuts and cranberries
• Quinoa-stuffed peppers
• Sweet potatoes and/or mashed potatoes
• Wild rice casserole
• Roasted Brussels sprouts
• Green beans with slivered almonds
• Cranberry sauce with cloves and orange zest
• Petite peas and carrots
• Roasted roots and other veggies

Try this delicious roasted veggie recipe:

 Asparagus, Onions, and Mushroom Roast

This is tasty vegetable medley that will make a great side dish on your Thanksgiving table. Feel free to throw in your favorite veggies.

Yield:
4 servings

Serving size:
½ cup

Prep time:
5 minutes

Cook time:
30 minutes

Each serving has:

85 calories
7 g total fat
1 g saturated fat
0 g trans fat
0 mg cholesterol
28 mg sodium
5 g carbohydrates
2 g fiber
2 g sugars
2 g protein
7 percent iron

You need:

1 1/2 cups asparagus spears
1 small yellow onion, quartered
2 cups baby bella mushrooms, chopped
2 Tablespoon extra-virgin olive oil
1 small handful of fresh basil leaves
Salt and ground black pepper

1. Preheat the oven to 375 degrees. Put asparagus, onions, and mushrooms in a roasting pan and drizzle with olive oil. Sprinkle basil over veggies and season with salt and ground pepper. Stir to coat with oil.

2. Roast in the oven for 20 minutes, stir, and put back into the oven for 10 more minutes, or until veggies are golden brown and tender. Serve immediately.

This recipe is courtesy of The Essential Guide to Healthy Healing Foods by Victoria Shanta Retelny, RD, LDN.

New research shows that women who exercise regularly spend as much time sitting as women who don’t, which can have significant health consequences, according to the study by Northwestern University Feinberg School of Medicine.

Past studies have shown that people who sit for extended periods of time—even those meeting exercise recommendations—are more likely to develop chronic conditions such as diabetes, obesity, cardiovascular disease and some cancers.

“We all know someone who gets a good workout in every day, but then spends a large portion of their day sitting in front of a computer with few breaks,” said Lynette L. Craft, study co-author and an adjunct assistant professor in preventive medicine at Northwestern. “If these people could replace some of the sitting with light activity—just getting up, moving around, maybe standing up when talking on the phone, walking down the hall instead of sending an email—we do think they could gain health benefits.”

We can do that, right?

“If these people could replace some of the sitting with light activity—just getting up, moving around, maybe standing up when talking on the phone, walking down the hall instead of sending an email—we do think they could gain health benefits.”

While many of the women in the study met or exceeded the recommended 150 minutes of physical activity per week, in reality only a fraction of the women’s days were spent being physically active. The women in the study spent an average of nine hours a day sitting.

“I think some people assume, ‘If I’m getting my 30 to 40 minutes of physical activity a day, I’m doing what I need to do for my health,’” Craft said. “Of course, exercise is very important and is associated with many positive health benefits, but negative health consequences are associated with prolonged sitting, and this study shows that just because you’re physically active doesn’t mean you’re sitting less.”

The Northwestern research was published in the International Journal of Behavioral Nutrition and Physical Activity.

The Lynn Sage Breast Cancer Foundation, the Avon Foundation and the Edward G. Schlieder Educational Foundation supported the study.

“The evidence clearly shows that less frequent cervical cancer screening is warranted,” says David Chelmow, MD, chair of obstetrics and gynecology at Virginia Commonwealth University School of Medicine in Richmond, who helped develop the new guidelines.

Under the new guidelines — previously updated in 2009 — women age 30 to 65 who have had three normal Pap tests for three years in a row should have a Pap test combined with human papillomavirus (HPV) testing every 5 years. If HPV testing is not available, women can get a Pap test by itself, every 3 years. ACOG advises that women younger than 21 do not need screening for cervical cancer or HPV, whether they are sexually active or not.

Women age 30 to 65 who have had three normal Pap tests for three years in a row should have a Pap test combined with human papillomavirus (HPV) testing every 5 years.

“We know that HPV infections are very common but most are transient and don’t progress to cervical cancer,” says Dr. Chelmow. Only a fraction of women with chronic HPV infection will have cervical abnormalities that cause cancer. In addition, even if cells are precancerous, it takes years for them to convert into invasive cancer, according to ACOG.

“With co-testing (both Pap smear and HPV testing), screening every five years provides an excellent balance between achieving extremely low cancer rates while avoiding the potential harms of unnecessary interventions,” says Dr. Chelmow.

Before you reach for the phone and cancel that appointment, remember that annual wellness exams are still necessary because they include a clinical breast exam, pelvic exam and counsel on any other gynecologic problems you’re having.

The guidelines also suggest that women age 21 – 29 years get screened for cervical cancer every 3 years rather than every 2 years. Women older than 65 years no longer need screening if they meet certain qualifications.

Always talk with your doctor, because some women will need more frequent screening.