Introducing Prevent By Dr. Michele Couri, MD, FACOG, ABIHM

The Importance of Knowing One’s Breast Cancer Risk Score

In the last edition of our newsletter, I wrote about the importance of knowing one’s breast cancer risk score.  As you may recall, the average woman’s risk of developing breast cancer in her lifetime is 12%.  But, my question to you is how many of us are average?  What, if after genetic testing or after a software-based model calculation, we find out that our breast cancer risk score is >12%.  What can we do to lower or modify that risk score?  You also may recall that 30% of breast cancer cases are linked to a poor lifestyle.  That modifiable risk factor is very much in our control.  Our lifestyle is a powerful driver of either disease or lack thereof.  How do we harness the power of lifestyle as it pertains to our risk of developing breast cancer?  Allow me to introduce you to the Prevent Program here at the Couri Center.

Introducing Prevent By Couri

Prevent By Couri is a lifestyle-based wellness program designed to help women lower their individual risk of developing breast cancer. Grounded in both the science of Western medicine combined with the healing traditions of Integrative Medicine is born a program that through a thorough data gathering process and a comprehensive laboratory evaluation provides us with information that we use to formulate a personalized plan unique to each individual. This program will address nutrition, exercise, hormone metabolization, inflammation, and detoxification as it pertains to lowering the risk of breast cancer.   All women are candidates for Prevent, but it is particularly well suited for women whose breast cancer risk score is >20%.

How Do I Determine if I am at High Risk?

I encourage all women age 40 and older to have their breast cancer risk score calculated.  This can be done in one of two ways.  The first option is relevant for women who qualify for genetic testing for breast and ovarian cancer.  If you meet criteria to have Myriad genetic testing performed, the test will include a breast cancer risk score based on your individual genetic makeup and non-modifiable factors including but not limited to your age, family history of cancer, breast density, age at first period and age at first pregnancy.  To have a better idea if you qualify for Myriad genetic testing, please take the hereditary cancer quiz at  For women who do not qualify for genetic testing, your breast cancer risk score can be calculated using a computer-based software model that incorporates several of the variables listed above.  We would love to help you find your score.

How Can I Get Started?

The first step is to make an appointment with Leslie Rusch-Bayer, our Registered Dietitian.  She will help guide you down the right path for testing and then get you enrolled in Prevent, if appropriate.  The New Year is a great time to invest in your health.  Know your number, change your destiny.  Oh, the power of the female spirit – it is like nothing else.

To Your Health,

Dr. Couri

2-Day Supplement Sale!

Couri Center’s 2-Day Supplement Sale

Friday, December 28 & Monday, December 31


Couri girl Bone Health packets for Osteopenia and Osteoporosis, and ProbioMax® DF by Xymogen

Hurry by our retail center and stock up on your favorites!  Hours: 8 – 4:30 PM daily

Couri girl Osteopenia packets 30-day count $10 OFF. Reg. $63.02 

Limit-3 per customer. While Supplies last!

  • Provides essential vitamins & minerals
  • Essential in maintaining proper bone health

Couri girl Osteoporosis packets 30-day count $10 OFF  Reg. $105.44

Limit-3 per customer. While Supplies last!

  • Provides essential vitamins & minerals
  • Collagen
  • Both essential to rebuilding and maintaining healthy, strong bones

ProbioMax® Daily DF by Xymogen-30 count only $5 OFF   Reg. $39.44

Limit-3 per customer. While Supplies last!

Couri Center ProbioMax daily DF probiotic

  • 30 Billion CFU Probiotic
  • Helps Maintain a Healthy Intestinal Microecology
  • Supports the Natural Immune Response
  • Supports Bowel Regularity
  • Supports Lactose Digestion

Do I Really Need an Antibiotic? By Renee Alwan Percell, MMS PA-C


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As we start the New Year, many of us will make a New Year’s resolution involving our health, diet, or exercise.  One thing we must keep in mind this time of year is healthy habits to avoid the common cold, the flu, sinus infection, and pneumonia.  A healthy habit that many of us forget is when it is appropriate to use an antibiotic for our illnesses.  Everyone plays a critical role in improving antibiotic use and preventing antibiotic-resistant illnesses.  The CDC has started an initiative for health care workers, hospitals and nursing homes to guide providers in evidence-based findings on when an antibiotic is appropriate for treatment.  Working together we can improve and protect the health and well being of everyone.  This is crucial for the well being of generations to come.  We need to be sure the life-saving antibiotics we have today will continue to be useful for years to come.

What are Antibiotics Used for?

We rely on antibiotics to cure life-threatening illness. Antibiotics do not come without risk, however.  Antibiotics can cause diarrhea, GI upset and allergic reactions.  Also, when we take an antibiotic, it kills not only the harmful bacteria but also the good bacteria.  Killing these good bacteria will make you more susceptible to other illness.  This can take your body months to recover, therefore posing a risk to you for getting another illness.

Most importantly, the overuse of antibiotics has created bacteria that are becoming resistant to the antibiotics we have available.  This makes it extremely difficult for some to improve without complications from antibiotic-resistant bacteria.  Over 2 million people are infected with a resistant bacterium where nearly 23,000 people end up dying as a result.

An antibiotic is not necessary for the common cold, bronchitis, the flu, most sinus infections, and sore throats.  Up to 70% of antibiotics given are not needed.  That means that 7 out of 10 of us take an antibiotic for an acute respiratory infection or something similar that we did not really need. That causes a cascade of effects making our bodies weaker in the long run.  Antibiotics are necessary for the treatment of urinary tract infections, pneumonia, and strep throat.

What Can I do to Stay Healthy?

There are many things you can do to stay healthy.  Healthy lifestyle habits of having a good diet, drinking plenty of water, getting enough sleep and exercise regularly will help your body fight off infection when exposed.  Also taking a daily vitamin and probiotic will help to maximize your body’s ability to fight infection.  That doesn’t always work, so when you start feeling like you may be getting a cold, you can begin a supplement like OlivDefense.  This is a supplement we have at the Couri Center that lessens symptoms and limits the duration of your illness.  It promotes immune function and provides antioxidant activity.  Resting and drinking plenty of water when you feel something coming on also makes a big difference in limiting your symptoms.

Stay warm and healthy this winter.

Be well

Renee Alwan Percell, MMS PA-C


Do Foods Really Affect Your Skin? By By Leslie A. Gilstrap, Licensed Esthetician

Could what you eat affect your skin?  YES! The food you eat can keep your body in good health, but a poor diet may affect not only your waistline, but also your skin.

Processed foods:

Processed foods (packaged cookies, chips, candy, frozen dinners) These foods can cause blood sugar spikes. When blood sugar rises, your skin will produce more oil (sebum). This oil lingers causing bacteria to breed, which leads to acne.  Eating these foods every now and then won’t hurt, just do not make them staples in your everyday diet.

Refined carbohydrates:

Refined carbohydrates (breads, pastas, pastries) These foods can fill us up quickly, but offer little nutritional support.  A spike in blood sugar can affect not only oil production, but hormone levels leading to possible breakouts. Too much sugar also breaks down collagen and elastin. Try increasing your activity or exercising to help boost your energy. This is more effective than loading up on empty calories. Exercise will also help detoxify your pores at the same time.

Excess salt:

Excess salt (chips, french fries, popcorn, salted nuts) Any high sodium food can cause the skin to weaken and age faster.  Sodium makes you retain water which causes bloating and puffiness of the body, including the face. Try using herbs and spices to season your food instead of salt. It is an easy, cost-effective change and often more flavorful.


Caffeine (coffee, soda products) Caffeine thins and dehydrates skin making you look older and dull. One cup of coffee is not harmful, just avoid relying on coffees and sodas as your only liquid intake.  DRINK WATER! Its one of the best things you can do for your skin.

Fast Food:

Fast food ( burgers, pizza, fries, tacos) Most fast food items are fried in refined and processed oils giving them an elevated, unhealthy fat content. This is hard for the body to break down and cleanse out of the system, which in turn may possibly lead to other health and skin problems.


Dairy (milk, ice cream, yogurt) Most cows supplying your milk are given hormones to increase their supply. These hormones make the way into your body and cause skin problem as well as other digestive issues.

Consequences will always arise if you do not prioritize a healthy lifestyle. With anything in excess, side effects occur, as well as, weight gain, high cholesterol, and irritated skin. If you focus on limiting your intake of possible dietary triggers, you may notice an improvement in your body and your skin.  If you feel there is a link between the foods you eat and how your skin looks/the way you feel, consider food sensitivity testing.  It’s an easy way to know for certain.

Fun Fact:

When possible you can substitute sugar with honey.  It’s a natural humectant (used to reduce the loss of moisture) and loaded with antioxidants.

At home body exfoliant:

  • Pour about 1/4 cup of warm honey into a small bowl.
  • Stir in about a 1/2 cup of old-fashioned oats.
  • Mix well.
  • Exfoliate skin in circular motions and rise in the shower.

To Healthy Skin,

Leslie A. Gilstrap, Licensed Esthetician

How to Navigate the World of Omega-3 Fatty Acids By Leslie Rusch-Bayer, RD, LDN CPT

With topics like inflammation and disease prevention headlining many media sources, the topic of fish oil is something most people have heard of, but do not really understand.

Omega-3 fatty acids are also known as essential fatty acids because the body cannot create them on its own. Essential fatty acids must be consumed from the diet. The three most noted omega-3 fatty acids are eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and alpha-linolenic acid (ALA). EPA and DHA are primarily found in marine life like algae and cold-water fish. ALA is found in nuts and seeds. It is possible for ALA to convert to DHA and EPA, but research shows only a minimal amount of ALA converts to EPA and DHA.

Why do we need omega-3’s?

Omega three fatty acids are necessary for many healthy functions. EPA is shown to improve heart health, lower triglycerides, lower blood pressure, and heart rate as well as lower inflammatory responses. DHA is necessary for cell membranes, eye health, and brain health. ALA is mostly used for energy.

Omega-3’s through the lifespan

Research has shown omega-3 fatty acids to be important at different stages of development. EPA and DHA taken during pregnancy are shown to prevent not only premature deliveries but also overdue pregnancies, therefore leading to an optimal pregnancy duration. Mothers who took omega-3 supplements during pregnancy and while breastfeeding were also shown to have positive outcomes in their children’s brain development. Research shows that children analyzed at nine months had better problem-solving skills than children whose mothers did not take fish oil, and children examined at two and a half years showed to have better hand-eye coordination. Research is also showing children who are given omega-3s during pregnancy and breastfeeding may have a lowered immune response, which may protect them against allergies.

EPA and Heart Disease

Three main studies have taken place supporting the importance of omega-3 fatty acids during adulthood. The GISSI Prevention Trial gave one gram of omega-3 fatty acids daily for three years to participants who had already had a heart attack. The trial showed a 50% less risk of dying from sudden cardiac death compared to those who just took a placebo. In the JELIS study, participants took EPA plus a cholesterol-lowering statin. These participants were shown to be less likely to have a massive coronary event compared to those who only received a statin. This year the REDUCE-IT trial released its findings. Participants who had elevated cardiovascular risk along with other comorbidities, AND elevated triglycerides, took four grams of EPA daily or a placebo. After almost 5 years, there was approximately a 25% relative risk reduction of a cardiovascular event. This 25% relative risk reduction was seen ON TOP of taking a statin. Lowering LDL cholesterol (bad) only reduces risk by 25%-35%.  EPA reduces relative risk by an additional 25%. The REDUCE-IT trials state “this is the single most impressive advance for preventative cardiovascular drug therapy since the advent of the statins.”

DHA and Alzheimer’s Disease

Alzheimer’s Disease, dementia, and decreased cognitive thinking are all brain-based diagnoses where risk doubles every five years after age 65. Due to the commonality of the Standard American Diet in the United States, low DHA levels are common. DHA is protective against many brain mechanisms, especially head trauma, amyloid toxin production, diabetes, and cardiovascular disease. Many clinical trials are underway regarding DHA and age-related cognitive decline. EPA and fatty acids are proving to be a low cost, effective therapy for not only treating, but preventing cognitive decline.

How to choose fish oil?

Not all fish oils are created equal. Here is a list of standards to make sure your omega-3 product is providing:

  1. At least 1000mg of EPA+DHA daily. This is a therapeutic dose for healthy individuals. Patients who have a history of cardiovascular disease, elevated triglycerides, diabetes or other inflammatory diseases will require more.
  2. Free of heavy metals. Many fish, including certain species of mackerel, contain high levels of mercury, environmental contaminants, and heavy metals. Companies like Nordic Naturals and Xymogen carry certifications that prove they maintain the highest purity possible.
  3. Triglyceride or monoglyceride form. Triglyceride form is the natural form found in fish and a form that is easy for the body to ingest and absorb.
  4. Free of synthetic fats. No additives.
  5. No foul, bad fish odors. The only time fish smells or tastes bad, is when it is rancid. The same theory works for fish oil.
  6. Sustainably sourced.

The providers at the Couri Center understand the value of quality omega-3 intake. If you prefer to consume omega-3 foods naturally, look for wild-caught mackerel, salmon, oysters, sardines, and anchovies. Flaxseed, chia seed, and walnuts also contain omega-3 fatty acids, but mostly in the form of ALA. If you are looking to increase your DHA or EPA, cold water fish or vegan fish oil (algae-based) is your best option.

How can I learn more about what supplements are right for me?

Inflammation and chronic diseases are increasing in prevalence. Omega-3 fatty acids are an easily tolerated, cost-effective way to help fight inflammation, improve brain health and lower your risk of cardiovascular events. If you have questions regarding omega-3 fatty acids, how to choose the right product or how they may improve your health, I encourage you to call the Couri Center and schedule a nutritional consultation.

Leslie Rusch-Bayer, RD, LDN CPT



NEW OlivDefense™: Cold & Flu Defense

Another way to help fight off colds and flu includes using OlivDefense™.  OliveDefense™ features science-based, patented Immune Guard® plus olive extract and elderberry to support the body’s natural immune defense mechanisms.

It’s that time of year again, the time when you start hearing coughing and sneezing throughout the home and office while a box of tissues is placed conveniently near your computer keyboard.  According to the CDC, people are most contagious during the first 2-3 days of contracting a cold and almost immediately and for about 5 days thereafter after being infected with the flu – even before symptoms develop.  However, there are many actions you can take to prevent the spread of cold and flu viruses at home and work:

  • Wash your hands for at least 15-20 seconds with soap multiple times per day
  • Dry hands with an air dryer or clean paper towel
  • Use a paper towel to open a bathroom door
  • Use hand sanitizer between washing
  • Avoid touching your face, eyes, or rubbing your nose
  • Drink plenty of fluids
  • Get lots of fresh air
  • Exercise regularly and frequently
  • Eat healthy foods like fruits and vegetables
  • Don’t smoke and decrease alcohol consumption
  • Relax – stress can lower immunity
  • Get plenty of sleep (7-9 hours is optimal)
  • Avoid contact with known allergens – allergies affecting the nose or throat may increase the chances of getting a cold or flu