Health & Wellness 2014

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Health & WELLNESS OCTOBER 2014 | A SPECIAL SUPPLEMENT TO

Angola & Eden-North Collins Pennysavers

Embracing an Active Lifestyle How to beat the couch potato curse

Dominate Your Diet

Avoiding the pitfalls that can derail your diet

Got Migraines? What triggers migraines


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• Family Practice for every age, including infants and children. • Sick call availability same or next day • Evening hours until 7:15 available and Saturday hours Dr. Morris Cavalieri Dr. Henna Sheikh Dr. Mary Rykert-Wolf Dr. Tariq Sheikh Eric Dibben, PA Angel Macko, PA-C

Certified DOT physicals are available

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Angola and Eden-North Collins Pennysvers • October 2014

Health & WELLNESS 3

Health & WELLNESS 4

How to beat the couch potato curse

5

The dangers of belly fat

6

How to sneak fruits and vegetables into any recipe

6

Is buying organic worth the cost?

7

What triggers migraines?

8

Atrial fibrillation: Curative procedure and new medications for stroke prevention

10

Avoiding pitfalls that can derail your diet

of Eden

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4 Health & WELLNESS Angola and Eden-North Collins Pennysvers • October 2014

How to beat the couch potato curse

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iet and exercise make great bedfellows for men and women looking to live a healthier lifestyle. A combination of a healthy diet and regular exercise makes it easier for men and women to maintain a healthy weight while lowering their risk of various ailments, including heart disease and diabetes. A heightened awareness of what makes for a healthy and unhealthy diet coupled with the increased availability of healthy foods has helped many people smoothly transition to a healthier diet. But many people still struggle to find time to exercise every day. Commitments to work and family can make it difficult to squeeze in regular workouts, and the call of the couch is often more appealing than a trip to the gym at the end of a long day juggling both personal and professional obligations.

But exercise is integral to a healthy lifestyle, so it’s important that men and women take steps to incorporate exercise into their daily routines. Figure out when you’re free. Finding free time is perhaps the biggest hurdle adults must clear when attempting to exercise more. Track your daily schedule for a week or two, making note of down times during the day when you might be able to squeeze in 30 to 60 minutes of exercise. If you notice you’re spending your lunch hours catching up on personal emails or surfing the Internet, then consider joining a gym near your office and turning those lunch hours into workouts. If your mornings are not dominated by getting the kids ready for school, then wake up a half hour earlier each morning to squeeze in some time on the treadmill. You likely have some down time with regard to your daily schedule, and identifying such time is the first step toward making better use of it. Make it a team effort. Daily exercise is not just good for adults; it’s great for kids, too. Parents looking to fit more physical activity into their daily routines should consider involving their children, many of whom are dealing with a fitness crisis of their own. According to a 2014 report in the Journal of the American Medical Association, childhood obesity has more than doubled in children and quadrupled in adolescents over the last three decades, putting youngsters at increased risk for cardiovascular disease, prediabetes, bone and joint problems, and sleep apnea. Parents can make daily exercise a family affair, which increases the time they spend with their children while ensuring their kids stay fit as well. Men and women

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without families also can make daily exercise a team effort by working out with a friend or significant other. The buddy system often proves motivational, encouraging men and women to exercise even on those days when the couch is calling.

Make exercise more interesting. Many workout routines fall by the wayside because they simply do not engage men and women no matter how motivated they are to lose weight. An hour on the treadmill can seem like an eternity to certain men and women, who can benefit by choosing workout routines that are less monotonous. For example, Zumba is a combination of dance and aerobic exercise that is growing in popularity. In lieu of spending an hour on the treadmill or elliptical machine, Zumba participants get an

equally if not exceedingly challenging cardiovascular workout that many find more fun than traditional aerobic exercise thanks to its incorporation of dance. For those without such happy feet, bring a tablet along to the gym and catch up on your favorite television shows or a good book during your cardiovascular routines. The more interesting you find your workout routine, the more likely you are to find time for that routine every day. Choose an accessible routine. When planning your workout, make it as accessible as possible. While sports like kayaking and mountain bike racing make for great exercise, such activities are not readily accessible to many working professionals with busy schedules. Join a gym that’s only a short drive from home, or purchase some gym equipment you can set up in your own home. The more accessible a workout routine is, the more likely you are to embrace that routine. The call of the couch can be difficult to ignore. But the side effects of a sedentary lifestyle can be grave, so men and women should work to find ways to include exercise in their daily routines.

Accepting New Clients and Insurance

Christina Lowman RDN CDN


Angola and Eden-North Collins Pennysvers • October 2014

The dangers of belly fat

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octors use many different methods to assess their patients’ health. Measuring the fat in a person’s midsection is one indicator physicians may rely on more heavily in the future as they look to pinpoint potential health risks before they become something more serious. Belly fat is much more than an eyesore, as it poses a serious health risk doctors are only just beginning to understand. A recent study on belly fat presented at the European Society of Cardiology Congress confirmed that belly fat is far more dangerous than many people think. That’s because a large stomach may not only be comprised of subcutaneous fat, or the fat contained under the skin. Very often visceral fat, or the type of fat that surrounds internal organs, is a contributing factor to girth around the midsection. Visceral fat, also know as intra-abdominal fat, is linked to a variety of health problems, including high triglycerides, high blood pressure, high cholesterol, and high blood sugar. Every person has some amount of belly fat, even those with relatively flat abdominals. Visceral fat provides cushioning around the organs and is actually beneficial in small amounts. It’s when visceral fat becomes too plentiful that it can pose a problem. According to Kristen Hairston, MD, an assistant professor of endocrinology and metabolism at the Wake Forest University School of Medicine, visceral fat doesn’t just sit dormant; it plays an active role in the body’s production

of a number of potentially harmful substances. Researchers are studying if visceral fat secretes inflammatory molecules in higher amounts than other types of fat. These molecules can contribute to various health ailments. A person’s ideal weight is not necessarily based on pounds on the scale. Rather, individuals should use other measurements to determine propensity for belly fat. Having a “pear shape” where the hips and thighs are larger than the waist can actually be safer than an “apple shape,” where the waistline is larger. People concerned about belly fat should use a measuring tape to measure girth and determine if there is a potential problem. Place the measuring tape around the waist at the navel. The measuring tape should be level and stretch around the midsection. Women want a waist measurement of less than 35 inches. Men should measure in at less than 40 inches. Measurements that exceed those figures may indicate excessive amounts of visceral fat. A hip-towaist ratio measurement also can be used. This ratio should be below .85 for women and below .90 for men. Anything higher is considered “at risk,” and a person should consider losing belly fat. The only precise way to measure visceral belly fat is to get a CT scan or an MRI. However, this is expensive and may not be covered by health insurance. It’s important to note that belly fat is not a problem exclusive to those who are overweight. Although it may not be as visible, thin people can have excess visceral fat as well. This is often the result of eating a healthy diet but failing to exercise regularly. There are ways to manage and reduce belly fat. Getting adequate exercise in conjunction with eating a healthy diet, getting enough sleep and managing stress can help. Losing belly fat can improve a person’s appearance and his or her overall health.

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Health & WELLNESS 5

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Do you experience a spinning sensation that lasts for a number of seconds when you roll over in bed, get out of bed, when you bend down to put on your shoes, or when you tip your head back to look upward? If so, then you may have benign paroxysmal positional vertigo (BPPV), also known as positional vertigo. Patients who have positional vertigo may benefit by treatment known as the canalith repositioning procedure (CRP). The procedure takes only a few minutes, and studies have shown that it is effective about 80% of the time in completely resolving positional vertigo. The cost of CRP is only $20

If you would like to schedule a CRP diagnostic/treatment session, call our office at 627-7759 For more information about positional vertigo or other services we offer, please visit our website. All fees are posted on our website.

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6 Health & WELLNESS Angola and Eden-North Collins Pennysvers • October 2014

How to sneak fruits and vegetables into any recipe F

ruits and vegetables are the building blocks of a healthy diet. But many people do not eat the recommended number of servings of produce. That’s especially true among growing children, who can benefit greatly from the vitamins and nutrients fruits and vegetables provide. According to the latest data from the NPD Group, a market research firm, Americans eat a

little more than half a cup of fruit and a cup of vegetables per day. This is less than half of what the government recommends. The data is similar in Canada, where researchers at Concordia University found that Canadian adults ages 30 to 60, especially those from lower socioeconomic backgrounds, aren’t consuming the daily recommended levels of fruits and vegetables. Anyone who eats roughly 2,000

calories per day should strive to consume between two to three cups of vegetables and two cups of fruit per day. Produce helps to fight disease because it contains healthy antioxidants, fiber, minerals and vitamins. Eating four cups per day may seem difficult, but there are many ways to incorporate fruits and vegetables into everyday recipes.

• Substitute pureed fruit, like figs, pears and apples, for oil in recipes for cakes and cookies. This will ensure the baked goods are moist but with a lot less fat.

•Divide your dinner plate into quadrants, filling half of the plate with vegetables, one quarter with meat and the remainder with a whole grain.

• Add fresh berries or raisins to breakfast cereals and oatmeal.

• Replace lettuce on a sandwich or burger with a fresh leaf of spinach. While you’re dressing your sandwich, add a slice of tomato, too.

• Add cauliflower or squash to boiled potatoes before mashing them to increase the nutritional punch and flavor of mashed potatoes. • Blend fruits and vegetables to create smoothies for breakfast or lunch on the go. • Bake hearty muffins or breads with sweet potato or carrots in the batter. • Mix stewed tomatoes in with your broth soup base to make a vegetable or chicken soup even more nutritious. • Opt for vegetables piled high atop a slice of pizza in lieu of meats or extra cheese.

DID YOU KNOW?

• Substitute fresh vegetables and fruit slices for chips when serving dips and salsas. Kale chips are growing in popularity. • Give children a cup of sliced grapes with their lunches as a refreshing and healthy snack. •Shred vegetables into a hearty “slaw” and top it with a vinaigrette or a typical mayonnaise-based dressing. • Blend other vegetables into your pasta sauce.

•Use vegetables instead of pasta in traditional dishes. Layer eggplant slices to make a lasagna. Or use a spiral slicer to slice zucchini or carrots when making homemade noodles. • Fruit salad is often a refreshing snack or dessert. Having fruit already diced in a large bowl makes it more convenient to eat and possibly more enticing to children. • Make a vegetable roll-up, filling pizza dough with broccoli or spinach and shredded cheese. • Mix together an avocado, 1⁄4 cup of cocoa powder and 1⁄4 cup honey to create a healthy alternative to chocolate pudding. • Use pureed vegetables to thicken cheese sauce for macaroni and cheese recipes. • Shred vegetables and add them to beaten eggs for omelets or scrambles.

Though organic foods tend to be more costly, men and women looking to shed a few extra pounds might find it’s worth a few extra dollars to buy organic dairy rather than more traditional and less expensive alternatives. In a study published in the Journal of Dairy Science, researchers found that grass-fed cows produced milk containing 500 percent more conjugated linoleic acid, or CLA, than cows that were fed grain. That’s a significant distinction for men and women looking to trim down, as CLA can help them burn more fat and gain muscle. Organic dairy products include cheese, milk and yogurt. Organic milk also has been shown to contain roughly 70 percent more omega-3 fatty acids than traditional milk. That, too, is important to note, as omega-3 fats have been shown to help prevent heart disease and stroke, two potentially deadly conditions that overweight men and women may be especially susceptible to.


Angola and Eden-North Collins Pennysvers • October 2014Health & WELLNESS

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At Eden Heights, retirement means places to be and things to do. It means time to focus on fun and friendships without the worries of day-to-day chores.

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Call to arrange a personal tour or consultation

What triggers migraines? A

common type of headache characterized by throbbing pain on one side of the head, migraines affect millions of people across the globe. Many people who suffer from migraine headaches get a warning that one is coming on. That warning manifests itself in a series of symptoms known as an aura, a group of vision disturbances. In addition, migraine sufferers may experience nausea, sensitivity to light and vomiting. While such symptoms are well known among migraine sufferers or those closest to them, what exactly triggers these painful headaches is less widely known. According to the United States National Library of Medicine, migraines may be triggered by the following factors: • Loud noises or bright lights • Alcohol • Stress or anxiety • Smoking • Caffeine withdrawal

• Changes in hormone levels during the menstrual cycle or changes triggered by the use of birth control pills (migraines occur more often in women than men) • Missed meals • Changes in sleep patterns • Certain foods, including those that contain monosodium glutamate, or MSG; baked goods; chocolate; nuts; peanut butter; dairy products; onions; foods containing tyramine, including red wine, aged cheese, smoked fish, and certain beans; and certain fruits, including avocado, banana and citrus fruits. Contrary to popular belief, migraine headaches are not a byproduct of brain tumors or other serious medical problems. That misconception likely stems from the similarity of certain symptoms of a migraine to symptoms of brain tumors and other serious ailments. More information about migraines is available at www.ncbi.nlm.nih.gov.

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8 Health & WELLNESS Angola and Eden-North Collins Pennysvers • October 2014

Atrial fibrillation: Curative procedure and new medications for stroke prevention By John J. Cai, MD. Atrial Fibrillation (AF) is a heart rhythm disturbance (arrhythmia). It is the most common cause of adult arrhythmia and it is the most common cause of stroke. During atrial fibrillation your may feel an irregular heart rate, fluttering sensation or palpitation. To understand atrial fibrillation we have to understand how the normal heart rhythm works. Everyone has a biological pacemaker called the SA Node where electrical impulse is generated, then it passes from the top chamber of the heart called the atrium to the bottom chamber of the heart called the ventricle. The ventricle is the pumping chamber of the heart that does all the work to pump blood throughout your body. In AF, because of electrical interference from blood vessels within lung circulation called pulmonary vein (PV), the atrial rhythm becomes very rapid and irregular which suppresses the normal SA node function. Therefore, your heart rate becomes very rapid and irregular, but sometimes it can be very slow but also irregular. Very often patients with slow heart rates end up with a permanent pacemaker. Because of the irregularity and rapid heart rhythm, many patients have palpitations, rapid heart rate and fatigue, sometimes with more severe symptoms such as lightheadedness, dizziness and congestive heart failure. Secondly, in AF, the atria no longer have normal contractility and the blood swirls around the atrium causing blood clots which results in stroke. That’s why doctors often put patients on blood thinning medication called warfarin (Coumadin). However, taking warfarin can be very tedious because you have to monitor blood level often to be certain it is within therapeutic range. Blood too thin will cause bleeding, not thin enough will result in strokes in AF patients. However, within the last 5 years there are several new medications on the market to replace the use of Coumadin for blood thinning purpose in AF that does not require blood check

just like any other medication you take. These medications are: Pradaxa (dabigatrab) and Eliquis (apixaban), both are taken by mouth twice a day. Xarelto (rivaroxaban) is taken as a once a day medication. All these medications and Coumadin are called anticoagulation medications (blood thinning medications). For specific usage of these medications, you will need to discuss with your doctor, a cardiologist or a heart rhythm specialist called an electrophysiologist. Although some AF patients may not have any symptoms, their risks of stroke are not less. As matter of fact, they may have a higher risk for stroke because of not seeking or being under medical care. In addition, long term AF can result in congestive heart failure (CHF) or needing a pacemaker at a much younger age than the general population. To diagnose AF, sometimes it can be very straight forward when patients present with symptoms and there is an abnormal electrocardiogram (ECG). Sometimes it can be tricky and other times it was only discovered after patients had a stroke. It is a very common adult heart rhythm disturbance. So, when you feel the palpitation you shall contact your doctors or contact a heart rhythm specialist. There are other tools we have to help you diagnose the disease or exclude from it such as Holter monitor, event monitor, 14 day wearable monitor or even an implantable device under your skin that won’t be permanent and it will be removed once the diagnosis or treatment plans are established. Treatment of atrial fibrillation is very dependent on your presentation, comorbidity and the preferences of the doctors you are seeing. However, all doctors agree that the prevention of stroke is most important in managing and caring for AF patients. Two major treatment strategies have been developed in the last 15 years: (1) To control heart rate (rate control) meaning you will still be in AF but your average heart rate is not too fast or too slow plus anticoagulation (blood thinning).

You Have a Choice For Your Heart Care NEW CARDIOLOGY PRACTICE PROVIDING FULL CARDIAC AND ARRHYTHMIA CARE • Office Testing: ECG, Holter monitor, stress test, and echocardiogram • Implantable cardiac defibrillator (ICD) / pacemaker implant, implantable loop recorder and follow-ups • Electrophysiology study (diagnostic testing for cardiac arrhythmia) • Specialized in radiofrequency ablation for Supraventricular Tachycardia, Atrial Fibrillation and Ventricular Tachycardia

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Accepting

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Cardiology / Electrophysiology Patients (Heart Rhythm Specialist)

Marian Professional Center 515 Abbott Rd., Suite 310, Buffalo ph (716)844-8754 • fax (716)240-9366 (2) To restore normal heart rhythm (rhythm control) through medications called antiarrhythmic drugs or a procedure called cardioversion which is a shock treatment to reset your heart rhythm back to a normal rhythm (sinus rhythm). However, most patients will revert back to AF after the cardioversion especially those patients who are not on antiarrhythmic drugs. Very often antiarrhythmic drugs used in treating AF are not very effective to control AF and have significant and even dangerous side effects. New Treatment (AF ablation): During the last 20 years, efforts have been focusing on treatment to cure AF. Research studies have shown that AF is not heart rhythm but the electrical interferences of the heart rhythm. The electrical interferences are actually from the blood vessels within lung circulation called pulmonary vein (PV). Therefore, if we can eliminate the electrical interference from PV we can restore normal heart rhythm and prevent the recurrence of AF. The procedure is called PV isolation (PVI) and it is a percutaneous catheter based procedure. You may be required to stay in the hospital overnight. Special trained cardiologists called electrophysiologists (heart rhythm specialists) perform such procedures and they insert

catheters through the veins by the groin and the catheters then advance to the heart using radio frequency energy to destroy the tissue that causes atrial fibrillation and eliminate electrical impulses from the PV. That is why the procedure is called PVI (pulmonary vein isolation). Well performed procedures have very high success and can reach to a cure rate at about 80%. Sometimes, patients may require a second procedure. However, the longer the patients are in AF, the lower the procedure success rates are. So call your doctors or find a heart rhythm specialist as soon as possible once you are diagnosed with AF, however, often we can help you with the diagnosis as well. The longer you are in AF, the more likely you may need a second procedure or a combined mini-invasive surgical approach in conjunction with percutaneous electrophysiology procedure. There are numerous procedure options and they are available through Dr. Cai’s practice. In addition, catheter ablation is not only for AF ablation but it also can treat different heart rhythm disturbances from supraventricular tachycardia and ventricular tachycardia. For more information please call 716-844-8754 (Office of Dr. John J. Cai) or visit www.johncaimd.com.


Angola and Eden-North Collins Pennysvers • October 2014

Creekside Physical Therapy

Health & WELLNESS 9

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10 Health & WELLNESS Angola and Eden-North Collins Pennysvers • October 2014

DAVID P. VONA, D.P.M. Medical & Surgical Specialist of the Foot

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Avoiding pitfalls that can derail your diet Diet and exercise go handin-hand for men and women looking to improve their overall health. While it can be tempting to skip a workout in favor of relaxing on the couch at home, the temptation to cheat on your diet is far more pervasive, as dieters know that a high-calorie treat or second helping is lurking around seemingly every corner. As difficult as it can seem to remain loyal to a diet, successful dieters know that anticipation plays a big role in staying true to a diet. Certain pitfalls can be expected when dieting, and knowing what those pitfalls might be and how to avoid them can make the difference between a successful diet and one that does not produce the desired results. Establish realistic and periodic goals. You should have a specific goal in mind when beginning a diet. But that goal should be realistic, and you also should set various smaller goals you can meet as you build up toward achieving your larger goal. Your ultimate goal as well as your periodic goals should be realistic and attainable, as nothing can derail a diet more quickly than failing to meet your initial goals. If necessary, speak to your physician about healthy weight loss and how much time it should take to meet your goals without compromising your overall health. Schedule your snacks. While snacking has derailed many a diet, grabbing a bite to eat between meals is not necessarily a dieter’s enemy. It’s what you eat between meals that can derail your diet. If you grab for the nearest snack without regard to nutrition, then you’re likely to find that your snacks are unhealthy foods that are compromising your diet. Scheduling your snacks in advance allows you to bring a healthy snack along to the office instead of forcing you to eat whatever happens to be available.

Make the cupboard commitment. Once you decide to go on a diet, clear your cupboards of all the unhealthy foods that contributed to your need to go on a diet in the first place. Remove fatty foods, salty snacks and sugary cereals from your cupboard, replacing them with healthier fare that won’t put your dietary goals in jeopardy. Reward your efforts. As you get deeper and deeper into dieting and meet your goals, reward your efforts. However, avoid the temptation to splurge on unhealthy food, as you don’t want to do anything to compromise your diet going forward and make all of your hard work up to that point all for naught. Rewards can include a shopping trip, tickets to a show or ballgame or any other special treat that won’t jeopardize your efforts. Knowing there is a reward on the way can motivate you to stay the course, especially on those days when doing so is particularly difficult. Rest up. Studies have shown that inadequate sleep inspires people to crave calorie-dense foods. In addition, lack of sleep compromises energy levels and makes it difficult to focus, which can affect your decisionmaking ability with regard to which foods you should eat. Adults typically need between seven and eight hours of sleep per night, so be sure to get adequate rest. Avoiding potential pitfalls that can derail a diet is an integral part of meeting your goals and adopting a healthier lifestyle.

Scheduling snacks, and replacing unhealthy fare with foods like fruits and vegetables, is one way to avoid compromising your diet.



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