Wellplan - Issue 19_2

Issue 19 > spring 2011

Healthy mind,

healthy body Maintaining good eating habits

Meet Zoe Keeping life simple on page 4

Inside 1 Welcome 2

Your Say Letters and Ask Our Expert

4

Simple. Useful Our guide to simple, easy-to-use private health insurance

6

Hot Topic Preventative Healthcare

7 Spotlight On Amanda Hagan

11

8 Expert Opinion Allergy action 10 Facts On Incontinence 11 Facts On Erectile dysfunction 12 Member in Focus Carol Bull 14 Focus On Generic medicines 16 Eat Well Are you getting enough iron?

20 Live Well The benefits of strength training 22 Australian Unity & You Information about member benefits, rebate changes, staff Q & A ... plus, your chance to star!

24 Understanding Your Cover

12 16

25 Rewards Exciting offers for members

16

Welcome

A question that our members frequently ask is why we don’t reward them for their loyalty or making no claims? We do value our members and their loyalty.

However, government legislation prohibits discrimination against those who claim – for example, by means of a ‘no claim’ bonus.

We work hard to find ways to reward our members, such as discounts for those paying for their health insurance premiums by direct debit or in advance, and offering discounts on Home and Contents, Car and Travel insurance.

Australian Unity’s main priority is to look after the wellbeing of our members. We are constantly finding new ways to improve their health and help them to get better overall value from their private health insurance.

One of the most important things Australian Unity has done this year is to listen carefully to our members, who have told us exactly what they want from their health insurance. The result is products that offer some of the highest dental benefits around, as well as women’s health initiatives in the allimportant areas of cervical cancer vaccinations and mammogram screening. We have also made health insurance simple and easy to understand to ensure our members know exactly what they are entitled to and how they can get the most from their benefits. These are some of the reasons why Australian Unity had the fastest rate of membership growth during the last quarter as compared with the top six health funds (PHIAC, August 2011).

Offering health advice and information through the pages of wellplan is another effective way of communicating with our members and encouraging optimum wellbeing. This issue addresses important topics, such as the benefits of resistance training and managing allergies, as well as providing a range of useful tips on staying healthy and enjoying life.

By offering you the best support and advice possible, we hope that you and your family will stay healthy for longer.

Amanda Hagan Chief Executive Officer – Healthcare

AWARD WINNING HEALTH INSURANCE 2009

Australian Unity Health Limited ABN 13 078 722 568 Information provided in this publication is not medical advice and you should consult with your healthcare practitioner. Australian Unity accepts no responsibility for the accuracy of any of the opinions, advice, representations or information contained in this publication.

Readers should rely on their own advice and enquiries in making decisions affecting their own health, wellbeing or interest. wellplan magazine is published by Edge on behalf of Australian Unity; edgecustom.com.au.

Change of address enquiries: 13 29 39

Contributors JESSICA GADD This issue’s cover story writer, Jessica Gadd, is a freelance journalist whose interest in health was piqued after a stint working on the UK National Health Service’s Choices website. Since then, she has edited several health magazines and written extensively on health issues.

THOMAS WALKER Thomas is an Accredited Exercise Physiologist who delivers Remedy Healthcare’s Coronary Artery Disease Program.

He aims at encouraging people to take responsibility for their health and enjoy the benefits of a healthy lifestyle.

ANDREW TURNER Andrew began his tenure in the health publication field as editor of the AMA (NSW) journal The NSW Doctor.

Now a freelance writer, Andrew has had numerous articles published on a diverse range of health topics, including podiatry, asthma and prostate cancer.

EDWINA MCDONALD Edwina is an Accredited Practising Dietitian and Exercise Physiologist who delivers Remedy Healthcare’s Coronary Artery Disease Program. She is a keen advocate for the important role that nutrition and physical activity plays in preventative health.

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your say

Letters Winning letter The article ‘In the Swim’ in issue 18 really struck a chord with me. As a child growing up in the western suburbs of Melbourne (nowhere near water!), learning how to swim wasn’t encouraged. When I hit 28, I had my first child and thought, “he’s going to grow up and be scared of the water just like me”. If I was terrified of the pool, there’s no way I was going to take him to learn, so the vicious cycle threatened to repeat itself for generations to come.

So, over the last summer holidays, I forced myself to pick up the phone and book myself in for private lessons.

As I drove to the first one, my heart was beating a mile a minute and I wanted to turn back home. But by the second lesson, I was so excited to be conquering my fear and building a new skill that I couldn’t wait for the next one. I attended twice a week and, much to my surprise, by lesson 10 I was off on my own!

Learning how to swim at age 29 is one of my proudest achievements and I am so happy that this confidence has not only prompted my younger sister to have lessons now but my mother, too! I would encourage anyone who has ever thought about it but has kept finding excuses to put it off to pick up the phone and book yourself in. You won’t regret it!

T. Downie, Tarneit, Victoria

write &

win 2 > wellplan

Important topic As a very media-resistant, sporadic reader of magazines, I must agree with C. Seabridge (issue 18) and congratulate you on wellplan. Its breadth of subject coverage is fairly impressive. I cannot remember, however, reading anything on incontinence. I find it hard to believe that mainstream media is not covering an issue that will affect one in five Australians, not to mention those attempting to care for them.

Adult incontinence can be a heart-rending, debilitating condition. Readers need the chance to consider options for treating the condition and I believe wellplan could inform readers on this issue.

D. Kefalas, Geelong West, Victoria Editor’s note: Thanks for your suggestion – please see page 10 for an article on incontinence.

Keep in mind I would like to congratulate you on such a strong emphasis on preventative healthcare and a forward focus on managing finite healthcare resources. When considering preventative health programs, I am often disappointed that mental health is ignored, despite the large social, economic and personal costs associated

with such concerns. Disorders such as depression and anxiety are often just as prevalent as physical health concerns, and the links between these and problems such as heart disease, diabetes and obesity should not be ignored. I would love to see more articles on simple steps people can take to improve their mental health.

E. Crome, Lane Cove, NSW Editor’s note: We have an article on mental health planned for a future issue, so please watch out for it.

Vitamin guide The article ‘Are Vitamins Vital?’ in issue 18 of wellplan got my attention. I feel that the section on ‘How to get what you need naturally’ was a very useful part of the article and I’ve cut it out and stuck it on the back of our pantry door. A quick reference guide is of great assistance and I thank you for it. It just goes to show that a few simple diet changes are all we really need to feel our healthiest.

I congratulate you on a magazine that is both informative and a great read!

P. Nigro, Pakenham, Victoria

Let us know your thoughts on wellplan and suggestions for future articles – and you could win some great prizes. The author of this issue’s winning letter wins a weekly family-sized fresh fruit and vegetable box delivered for 12 weeks through Aussie Farmers Direct ($420rrp), while the authors of the other published letters in the ‘Your Say’ and ‘Ask Our Expert’ sections will receive a Jenny Craig Healthy Living For Families cookbook ($34.95rrp) and a $50 VISA Gift Card. Simply email your letters to wellplan@australianunity.com.au or mail them to wellplan, Your Say, Reply Paid 64466, South Melbourne, Victoria 3205 (no stamp required). Please note that published letters may be edited.

Ask Our Expert This issue’s questions have been answered by Dr Dee Chohan, a practising Emergency Registrar at the Australasian College for Emergency Medicine.

If you have a health question for wellplan’s experts, write to wellplan@australianunity.com.au.

Please note that we may not be able to publish all correspondence.

I was diagnosed with gestational diabetes during my first pregnancy. I ate a fairly healthy diet and walked/swam before and during my pregnancy. What can I do to try to minimise getting gestational diabetes during my second pregnancy?

J. Keane, Hidden Valley, Victoria Gestational diabetes, or diabetes that develops during pregnancy, occurs when hormonal changes lead to insulin resistance. It affects 3–8 per cent of pregnant women and those at higher risk include Asians, Torres Strait Islanders, Aboriginals and those who have had gestational diabetes in the past. Obesity is another risk factor, so ensuring that you are a healthy weight – keeping a body mass index less than 25 – will help minimise the chance of developing gestational diabetes, as well as undertaking regular cardiovascular and weightbearing exercise (as often as four times a week). A healthy diet with lots of fruit, vegetables, pulses and foods with a low glycaemic index might also help to reduce the risk. Gestational diabetes increases the chance of having a larger baby, problems with delivery, a premature birth or miscarriage. It also increases the risk – for mother and baby – of developing type 2 diabetes later in life, which in turn raises the chance of heart and eye problems, strokes and kidney disorders1.

As we approach middle age, I’m sure we all suffer the odd aches and pains in the joints. There is a lot of discussion about joint health. You go to the health food store, supermarket or pharmacy to be faced with a seemingly endless array – glucosamine, fish oil, lyprinol and chondroitin. Which natural remedy is of benefit (if any) and how much should you take daily?

D. McQualter, New Gisborne, Victoria Osteoarthritis is more common the older we get, as the joints begin to suffer ‘wear and tear’ and the cartilage begins to break down, leading to pain and swelling.

Glucosamine is a natural component of the cartilage. Several studies have shown it does not make any difference in terms of halting the progress of osteoarthritis but it can help some people with the pain.

A recent review showed that chondroitin (another component of cartilage) and glucosamine made no difference to preventing arthritis and did not help with patients’ pain, whether taken alone or together. Lyprinol is sold as a natural anti-inflammatory supplement but studies have not shown it to actually help with joint pain. Fish oil, on the other hand, is proven to be of more benefit, with studies showing it helps ease joint pain and swelling, as well

I’ve heard a lot of conflicting information about the safety of energy drinks. Is there a limit to how many you should drink per day?

What are the risks associated with drinking too much?

J. Fredrickson, East Melbourne, Victoria Energy drinks typically contain large amounts of caffeine (equivalent to several cups of coffee), guarana, taurine, ginseng and gingko, as well as B vitamins and a lot of sugar. Most people should only consume one or two of these drinks per day, as these additives can have several side effects. The main risks are due to the high caffeine content. Excess caffeine can lead to palpitations, irregular heartbeat, high blood

as morning stiffness in patients who suffer rheumatoid arthritis. It has also been shown to help with osteoporosis and has benefits in preventing heart disease and lowering cholesterol. You should take fish oil to provide one gram daily of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplement, which are beneficial omega-3 fatty acids. Fish oils do increase the risk of internal and external bleeding from wounds, as they affect the clotting ability of blood, so you should let your doctor know you are taking them2.

pressure, seizures, hallucinations, anxiety, insomnia and an upset stomach. People who do not regularly consume a lot of caffeine can also suffer dehydration, due to the diuretic effects of this drug. Combined with alcohol, energy drinks can be quite dangerous, as they can impair judgement and increase risk-taking behaviours – such as drink driving – because they make you feel alert when, in fact, your blood alcohol level may be quite high. Energy drinks can also interact with many medications, such as monoamine oxidase inhibitors or warfarin, so you should check with your doctor whether these drinks are suitable for you at all. Additionally, there is no real nutritional benefit in energy drinks and the excess carbohydrate in them is not beneficial to anyone who is overweight3.

References: 1 Tobias DK et al. ‘Physical activity before and during pregnancy and risk of gestational diabetes mellitus: a meta-analysis’, Diabetes Care, 34(1): 223-9, Jan 2011. American Diabetes Association. ‘Standards of Medical Care in Diabetes—2011’, Diabetes Care, 2011.

Joanna Tieu et al. ‘Dietary advice in pregnancy for preventing gestational diabetes mellitus’, The Cochrane Library, Feb 2011. 2 Wandel S et al. ‘Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis’, British Medical Journal, 16; 341: c4675, Sep 2010. Tanveer Towheed et al. ‘Glucosamine therapy for treating osteoarthritis’, The Cochrane Review, Oct 2009.

Goldberg RJ et al. ‘A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain’, Pain; 129(1-2): 210-23, May 2007. Doggrell SA. ‘Lyprinol – is it a Useful Anti-inflammatory Agent?’, Evidence Based Complementary Alternative Med, Apr 21, 2009. 3 John P. Higgins et al. ‘Energy Beverages: Content and Safety’, Mayo Clinic Proceedings, 85(11): 1033–1041, Nov 2010. Reissig et al. ‘Caffeinated Energy Drinks – A Growing Problem’, Drug Alcohol Dependence, 1;99(1-3): 1-10, Jan 2009. Seifert et al.

‘Health Effects of Energy Drinks on Children, Adolescents, and Young Adults’, Pediatrics Vol. 127 No. 3, March 2011.

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Keeping it simple At Australian Unity, we are striving to develop a health insurance experience that is simple and useful. We are committed to helping you understand what you are covered for and how to use it to your benefit, as well as providing you with information and services that deliver the most positive outcomes.

Many a wise person has said it’s the simple things in life that make us happy.

Research conducted by Australian Unity in October 2010 shows that most of you would agree with this. Key findings from the research showed you want to understand what you are buying and how to use it most effectively. You also want the highest standard of customer service.

Australian Unity is listening and, as a result, we want to show you just how simple and useful our private health insurance is – to the point that ‘Simple.

Useful’ is our new motto. Here are just some of the ways we’re delivering on our motto.

Convenient claiming Making an Extras claim is now easier and faster – you can claim up to $300 instantly using our new iPhone app, over the phone or going online. Or, you can choose to send in your receipts for your Extras claim and, in most cases, we process your claim within 24 hours. We’ll even send you an SMS to let you know it has been approved and processed.

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SIMPLE. USEFUL

Get creative … and win an iPad2!

At Australian Unity, your children can remain on your family policy until the age of 23 – or 25 if they’re studying full-time*. That way, it is easier and more affordable for young adults to have health insurance coverage.

We will also reward you with a $100 VISA gift card for every new member you introduce to Australian Unity+.

Making a dent in dental Australian Unity members have no out-ofpocket cost for scale and clean treatments, examinations and mouthguards using one of our No Gap Dental Service providers^.

For a list of available providers, go to australianunity.com.au/nogapdental And LifeChoice and LifeChoice Plus Cover have no yearly benefit limits for preventative and general dental, so you pay less at the dentist.

Home run If you have Hospital Cover and your doctor says it’s medically appropriate to leave hospital early, Australian Unity’s Member Support Program will provide you with continued treatment and care in the comfort of your own home, including nursing, meal delivery, cleaning services and even childcare if you need it. This means you can leave hospital early or avoid a hospital stay completely.

On most Hospital and Combination covers, we offer chronic disease management programs over the phone for members with heart disease, type 2 diabetes and osteoporosis, so you can improve your health, stay well and stay out of hospital.

At your service One of the main things our research indicated was that you expect a high quality of customer service. Australian Unity is delighted to have been awarded the International Outstanding Customer Service Business Award by our industry peers at the International Customer Service Professionals Awards for two years running, in 2009 and 2010.

But you are the best judge of our customer service, so we were thrilled when you voted us ‘best health insurer for customer service’ in the 2010 Fairfax Smiles Survey. Perhaps it’s because our consultants use simple language that’s free of health insurance jargon, so you understand what you’re getting and how you can use it?

Whatever the reason, we’ll continue to strive towards delivering this outstanding level of excellence in customer service. * Approved course of study and child must not be married or in a de facto relationship + Offer not available if new members take out Extras only or Overseas Visitors Cover ^ Subject to yearly benefit limits

Zoe is a fictitious 30-something Australian Unity member and her mission is to show people just how useful Australian Unity health insurance can be. She’s the star of her own blog and a range of television advertisements that share her adventures as she uncovers things that help make life that little bit easier – like our health insurance.

We’re offering the chance for our real members to get involved in Zoe’s story.

In 200 words or less, describe your idea for a new Zoe television advertisement and you could win one of five 16GB Apple iPad 2s.

Remember to show how useful Australian Unity health insurance can be – we’ve listed some of the ways on the facing page.

To enter, simply visit australianunity.com.au/ zoecompetition iPhone and iPad are trademarks of Apple Inc.

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hot topic

Healthy

supportin the home Amanda Hagan, chief executive officer of Australian Unity Healthcare, talks about the preventative health programs and services that not only help to reduce hospital admissions and achieve better clinical outcomes than usual care, but also ensure members receive vital support in their own homes.

At Australian Unity, we recognise that wellbeing is much more than simply an absence of ill health, which is why we have invested significant resources over the past four years in supporting our members through a broad range of programs designed to keep them out of hospital. Our philosophy is to provide support and motivation targeted to our individual members’ needs within the comfort of their own homes.

Chronic diseases make up more than 80 per cent of hospital admissions. One Australian is diagnosed every seven minutes with type 2 diabetes, heart disease remains our biggest killer and more than 2 million Australians are living with osteoporosis.

All of which contribute to one Australian being admitted to hospital every five to six minutes. This burden leads to longer waiting times in the public hospital system and is a significant factor driving the rise in health insurance premiums.

Australian Unity prides itself on leading the industry with innovative ways of addressing the growing problem of chronic disease. We have developed a wide range of chronic disease health coaching programs aimed directly at reducing admissions into hospital and getting our members back into their homes sooner following hospitalisation. Our Rehab at Home Program and Member Support Program allow members to undergo rehabilitation in the comfort of their own home.

Excitingly, we are now in a position to talk about the results of various programs in 6 > wellplan

terms of improvements in clinical outcomes and reductions in hospitalisation. The latest result from our Bone Health Program, which supports members with osteoporosis, has demonstrated wonderful clinical results for participating members compared to usual care. It also has significantly reduced the number of hospitalisations for these members.

This is not only fantastic for the members involved but is also good for all members of our fund, as these results mean substantially lower claims, which in turn takes some pressure off premiums for all.

Members on eligible Hospital or Combination Cover meeting the eligibility criteria for Health Management Programs may be contacted

by Remedy Healthcare Group Pty Ltd or Health Providers Australia Pty Ltd (trading as Rehability) on behalf of Australian Unity and invited to participate. Remedy Healthcare Group Pty Ltd is part of the Australian Unity Group and Health Providers Australia Pty Ltd is a joint venture with Australian Unity.

Am I eligible?

You are eligible for the Remedy Chronic Disease Management Programs if you: Have been diagnosed with heart disease and/or had a cardiac event, such as a heart attack, angioplasty or insertion of a stent Have been diagnosed with type 2 diabetes Have several risk factors for developing type 2 diabetes Have been diagnosed with osteoporosis or are deemed at risk of developing it Call 1300 224 334 to find out more.

Am I at risk of type 2 diabetes?

1. Are you a man aged 45+ or a woman aged 50+?

5. Have you ever been found to have high blood glucose (blood sugar)?

2. Do you have a waist measurement greater than 100cm for men and 88cm for women?

If you answered ‘yes’ to three or more of the above questions, you may be at risk of developing type 2 diabetes. The great news is that many of the risk factors can be reduced.

3. On average, do you do less than 2.5 hours of physical activity each week?

4. Do you have high blood pressure or are you taking medication for high blood pressure?

To find out if you are eligible for our Remedy Chronic Disease Risk Management Program, call 1300 224 334.

SPOTLIGHT on

minutes with…

Amanda Hagan We talk to Amanda Hagan, chief executive officer of Australian Unity Healthcare, who tells us about her life as a busy working mum and explains why it’s important to understand everything your health insurance covers you for.

You have made a personal commitment to improve the wellbeing of Australians. Tell us about some of the programs available to Australian Unity members.

We offer a broad range of programs designed to allow Australian Unity members to get out of hospital faster, with the medical support they need at home. For example, we have our Rehab at Home Program for members who undergo an elective hip or knee replacement, as well as our Member Support Program for those who want to leave the hospital earlier and have treatment at home.

We also have a strong focus on chronic disease management, with programs that provide one on one health coaching and practical tools to educate members on how to manage major medical conditions. Some of these include the Type 2 Diabetes, Bone

Health and Coronary Artery Disease Programs – telephone-based programs designed to increase knowledge and confidence on how to self-manage these conditions.

What kinds of benefits do these programs provide to members and why do you believe they’re so important for your members to have access to them?

Being in hospital can be an emotionally stressful time that many people are unprepared for. With their doctor’s approval, members who access the Member Support Program can choose to leave hospital early and be treated at home instead.

At no extra cost, support such as personal care and private nursing care can be arranged.

There are also childcare services, nappy services, cleaners and even meal deliveries, easing some of the strain of taking care of yourself and your family while you’re recuperating.

These programs provide support and assistance that I believe help to improve our members’ wellbeing.

As well as Zoe and her sister Bec, we hear you’re also appearing in a new TV commercial with your daughter. Tell us about that.

I feel it is important that our members are more aware of the benefits that their Australian Unity membership offers. We decided to create

a television advertisement to spread the message. In the commercial, Zoe’s sister Bec has an accident and is taken to hospital for treatment. She is suffering from injuries that make it hard for her to care for herself, but she isn’t sick enough to need constant medical attention. By utilising the Member Support Program that Australian Unity offers its members, Bec is able to recover from her injuries in the comfort of her own home.

As this is a subject close to my heart and I feel so strongly about it, I appear in the commercial with my daughter to promote the program. I enjoyed doing the ad and it was an interesting experience learning what goes on behind the scenes.

When you are really busy, any accident or illness can be quite stressful. That’s why my approach to developing health insurance products and programs is to make them useful and convenient for our members.

Being the CEO of Australian Unity Healthcare, as well as a mum, you must lead a very busy life. How do you keep your life balanced?

As a busy working mum with lots of commitments and activities to juggle, I really believe it’s important to be able to spend quality time with family and friends. It creates balance and helps me keep things in perspective. I also enjoy being active and find regular exercise is a good stress release. Skiing and bike riding with my family are probably my favourites! wellplan > 7

EXPERT OPINION

Allergy

action

As many as one in three Australians are affected by allergies and experts say that number is on the rise.

But there are things you can do to manage, reduce or prevent allergic reactions – and wellplan’s allergy action plan shows you how…

WORDS Jessica gadd

Recent research has revealed that Australia boasts a dubious honour – one of the highest allergy rates in the world. This was highlighted recently in the Health Nuts Study (2010), which found that one in 10 Australian children had a food allergy.

“You could say this evidence points to Australia being on the verge of a food allergy epidemic,” says the leader of the study, associate professor Katie Allen, a paediatric gastroenterologist and allergist from Melbourne’s Murdoch Childrens Research Institute.

Professor Allen says the problem is that no one knows why allergy rates are increasing. Her current research explores some possibilities – our immune systems being less stimulated and therefore less hardy because of better hygiene and fewer parasites in our day-to-day environment; delaying the introduction of solid foods to infants until too late; and not receiving enough exposure to Vitamin D (sunshine).

“We do know it’s something to do with lifestyle factors because this change in prevalence has occurred more rapidly than we could have anticipated if just the genes were changing,” says Professor Allen.

Though the research is still underway, prior research conducted by Professor Allen and her team has supported the recent change to the Australasian Society of Clinical Immunology and Allergy (ASCIA) feeding guidelines on the correct age to introduce solids to children. “Our research to date has shown that it’s safe to introduce solids from four to six months and while it might not stop all children from developing food allergies, we are hopeful that we might find a reduction in the overall amount of children who do go on to develop them,” she says.

It’s important to remember that some reactions to allergens can be life threatening.

In an emergency, call 000 (or 112 if your mobile is out of phone range or credit).

Always seek medical help to diagnose allergies and beware of the many allergy treatments and tests available that have not been scientifically validated.

For those who do have allergies, the following guide may help to identify, treat and manage allergic symptoms for a better quality of life.

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ACTION PLAN 1

correct diagnosis

According to the Australasian Society of Clinical Immunology and Allergy (ASCIA), around one in three Australians will experience allergies at some point during their lifetime. Correct diagnosis is essential to ensure you’re treating the right thing.

Allergy testing determines which substances (allergens) you have an allergic reaction to.

The type of test depends on the type of allergy and may involve skin prick tests, blood tests, elimination diets or patch tests. Professor Allen advises that allergy testing should only be carried out under professional supervision.

She says it’s best to start with your GP, who can refer you to an allergy specialist if required.

2

Avoid the cause

People with food or insect allergies or some forms of eczema can usually avoid the cause of their allergy. But for people with allergies to things like pollen, dust mites, mould and animals, it can be more difficult to avoid exposure. ASCIA offers the following tips:

expert opinion

Pollen Hay fever (allergic rhinitis) sufferers know all too well the seasonal nature of their symptoms. The best way to avoid pollen is to stay indoors during pollen season (between late September and Christmas) and particularly before midday on sunny days or after thunderstorms. If you do go outdoors during this time, shower as soon as you can afterwards and use re-circulated air in the car.

Dust mites Wash sheets, pillowcases and soft toys weekly in hot water (55 degrees or hotter), which kills house dust mites and the allergen they produce. Do not use sheepskin or woollen underlays. Cover pillows, quilts and mattresses with dust mite resistant covers and wash the covers in hot water every two months. Avoid carpet if you can – if you do have carpet, vacuum it weekly but keep in mind that vacuuming increases the amount of house dust mite allergen in the air for up to 20 minutes.

Mould Mould is commonly found in spots with low air circulation, so try to ensure adequate natural ventilation where possible. Avoid going into homes or spaces that smell of mildew and don’t use evaporative coolers and un-flued gas heaters – these can increase mould (and dust mite) levels by releasing water vapour into the air. Remove mould with a mould reduction cleaner, such as bleach.

Animals If pets only cause a minor reaction, keeping them out of bedrooms and living areas may suffice. But it’s usually best for the animal to be completely removed from the home environment. Some animals, such as cats, often leave their hair on people’s clothing, so allergic reactions may sometimes occur in a public space even if the animal has never occupied that space. Similarly, horse allergy is quite serious and asthma can be triggered by even a small amount of horsehair on clothing.

3

Treat the symptoms

There are many over-the-counter medications you can purchase from a pharmacy, such as antihistamines or corticosteroid nasal sprays and creams, which are used to relieve such symptoms as sneezing, a runny nose, itchy eyes, wheezing, coughing and rashes. Always check with your doctor or pharmacist about which type is best suited for your symptoms.

Antihistamines work by interfering with the effects of histamine, the chemical that causes many allergy symptoms. Most reach their peak effectiveness within one or two hours, so it’s usually best to take them in advance if you know you’re going to be exposed to an allergen. You might also find that your particular symptoms require a treatment you can’t purchase over the counter, in which case you will need a prescription from the doctor.

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the longer term

Unfortunately, although treatable, there is no guaranteed cure for allergic disorders.

For some allergic disorders, such as stinging insects, hay fever, dust allergies and sometimes asthma, immunotherapy (also called desensitisation) may help.

Immunotherapy exposes a person to increasing amounts of a particular allergen (by injection or orally) to a point where they no longer have symptoms when exposed to ‘normal’ amounts of that allergen, or they experience reduced symptoms. It can take four to five months or more of immunotherapy treatment for results to show and the treatment may need to occur for up to five years (to decrease the chance that the allergies might return).

Immunotherapy can usually take place in conjunction with other allergy medications and should always be conducted under medical supervision.

5

Who can help?

General practitioner (GP) If you suspect you have allergies or you’re having difficulties managing your symptoms, the first step is to consult a GP. If necessary, the doctor will refer you to a specialist.

Symptoms that compromise the airways and breathing or result in collapse are termed anaphylaxis and urgent referral to an allergist is recommended.

Allergy specialist (also known as a clinical immunologist or an allergist) Allergy specialists assess and treat a range of common and rare diseases that involve the immune system, including food, drug or stinging insect allergic diseases, anaphylaxis, hay fever, sinus disease, asthma, hives, dermatitis and eczema. A referral from a GP is required to see an allergy specialist.

For more information, visit the ASCIA website allergy.org.au

Food allergy or intolerance?

Accredited Practising Dietitian (APD) Clare Evangelista explains that food allergy and food intolerance can both be grouped under the heading ‘food sensitivity’ but they are actually two different things.

She says that food allergy involves an immune response to the protein component of a particular food. Any amount will cause the allergic reaction in a susceptible person.

Food intolerance, on the other hand, is where certain food chemicals (natural or synthetic) cause irritation of nerve endings in a particular part of the body.

Small amounts of the chemical may be tolerated but a reaction will occur if larger amounts are eaten or small amounts are eaten regularly.

Evangelista explains that it is important to ensure that a person has been properly diagnosed to determine whether they have an allergy or intolerance, because, generally, allergic reactions can be life threatening but food intolerance reactions are more “quality of life threatening”.

Dietitian Accredited Practising Dietitian (APD) Clare Evangelista says anyone who suspects they have a food allergy can see a dietitian without a referral. An APD can provide tailored, expert nutrition and dietary information, including advice about food avoidance or limitation and how to ensure that your diet contains all the essential nutrients.

For more information or to find an APD in your local area, visit the Dietitians Association of Australia (DAA) website daa.asn.au Naturopath Eta Brand, vice-president of the Australian Naturopathic Practitioners Association (ANPA), says a naturopath can help support the immune system and decrease an inflammatory response by using herbs, nutritional or other natural medicines.

“But food allergies can be serious,” says Brand.

“In this case, a naturopath would work in collaboration with an allergy specialist.”

For more information about naturopaths and their therapies, visit anpa.asn.au wellplan > 9

facts on

Under

control

Incontinence can wreak havoc on people’s lives, but there are strategies and treatments for those who suffer the problem.

WORDS Andrew Turner

Control over our bladder and bowel function is something most of us take for granted. When nature calls we visit the bathroom and scarcely give it any thought.

But for a substantial number of Australians – and not just the elderly – it’s not so easy.

Involuntary leakage of urine or faeces, otherwise known as incontinence, is a problem that causes sufferers to feel self-conscious, embarrassed and reluctant to discuss.

A taboo topic it may be to some, but the incidence of incontinence in Australia is widespread. According to the Victorian Continence Resource Centre, a staggering 4.2 million Australians aged 15 and over suffer from urinary incontinence, while faecal incontinence directly impacts another 1.3 million.

The Economic Impact of Incontinence in Australia report, released during World Continence Week in June this year, reveals that the cost to the community in 2010, excluding the burden of disease, was a jaw-dropping $42.9 billion.

Who is at risk?

Susan McCarthy, clinical nurse consultant at the Victorian Continence Resource Centre, says that with the impact of pregnancy and childbirth on the pelvic floor muscles, it’s little wonder women make up the majority of incontinence sufferers at around 70 per cent. Declining oestrogen levels during menopause, which can affect bladder control, is another contributing factor.

While men’s pelvic floor muscles aren’t put through the same rigours as childbirth, the gradual weakening of muscles that occurs as part of the ageing process contributes 10 > wellplan

to incontinence in males over the age of 75.

An enlarged prostate, as well as surgery of the prostate, also contribute to the onset of incontinence in ageing men.

Other risk factors that can cause incontinence in both men and women include obesity, diabetes, multiple sclerosis, arthritis, heart disease, Parkinson’s disease, stroke and respiratory disease.

What are the causes?

McCarthy says the cause of incontinence is twofold. “Either they have a pelvic floor muscle that’s weakened and the tube from the bladder and rectum are not able to close off and cope with the pressure of the material that’s in the bladder or bowel,” she explains, “or it can be that the actual muscle of the bladder is overactive and it starts to contract before the person gets to the toilet.”

Urinary incontinence generally involves the leaking of urine with exertion, commonly known as stress incontinence, or leakage following the sudden desire to urinate, which is referred to as urge incontinence.

McCarthy says it’s important to keep a lookout for the warning signs. “People may not be wet or soiling themselves but they may notice they’re going to the toilet frequently and urgently and really cannot put it off, and that can happen both with bladder and bowel,” she says, explaining that this could potentially lead to incontinence.

People who experience urine leakage, no matter how small, should consult their GP,

advises McCarthy. “It’s easier to treat a small leakage than letting it go on,” she says.

Management and treatment While treatments such as electric stimulation can assist people suffering from incontinence to contract their pelvic floor muscles, McCarthy insists it’s best to prevent, or at the very least manage, incontinence through regular pelvic floor exercises and lifestyle factors, such as a high-fibre diet and avoiding constipation, minimising alcohol intake, keeping active, drinking the right amount of water and not smoking.

Pelvic floor exercises are critical, says McCarthy. “If a woman experiences leakage while coughing or sneezing, she should squeeze her pelvic floor muscles to brace against that increased pressure on the bladder, because that’s what causes the urine to leak out,” she explains.

“Or for the person who suddenly needs to go to the toilet, and they rush to the toilet and leak, we teach them to stop, stand still – which is counterintuitive to what they want to do – and do a pelvic floor squeeze.”

For further information or advice, call the National Continence Helpline on 1800 33 00 66 or email helpline@continence.org.au

facts on

Talking about

tackle

A doctor should be the first port of call for men seeking help with erectile problems.

WORDS Andrew Turner

As with many health matters concerning the area south of the belt, erectile dysfunction remains one of those unmentionable topics for lots of Australian men.

According to Andrology Australia, it can happen at any age and affects at least one in five men over the age of 40 and about two in three over the age of 70, causing potentially devastating results to a sufferer’s self-esteem and even their relationships.

Professor Robert McLachlan, director of Andrology Australia, defines erectile dysfunction as “a failure to establish and maintain an erection adequate for satisfactory sexual activity”. As a normal erection relies on healthy nerves and blood vessels that allow blood flow into and out of the penis, he says, an inability to attain an erection is often the first sign that blood vessels aren’t functioning as they should be and can be a symptom of other physical health problems.

While psychological factors, such as depression or anxiety about sexual performance, are sometimes the underlying cause of erectile dysfunction, around three in four cases are attributed to physical causes, according to Sexology Australia.

High cholesterol, heart disease, diabetes and high blood pressure are the main culprits, as well as the post-operative effects of surgery to the prostate in some cases.

“You may have diabetes or high blood pressure and this might be the first symptom of it,” explains Professor McLachlan. “Your GP is the best person to talk to because they

can conduct a proper health assessment to determine if there is an underlying problem.”

Depending on their findings, they may refer a patient to a specialist or continue working with them individually, addressing the underlying triggers of the condition by devising a regime to ensure regular exercise, a healthy diet and the attainment of optimum weight – lifestyle factors that Professor McLachlan describes as being “associated with positive benefits for erections”.

In some cases, a GP may prescribe tablet medications, otherwise known as PDE5 inhibitors, to help treat the condition. In a minority of cases, where the tablets aren’t effective and a man suffers from severe erectile dysfunction, the next tier of available treatments includes vacuum pumps, intra-penile injection therapy and implants, which can be successful for men who are unable to attain erections, for example after extensive prostate surgery or with other conditions with severe blood vessel or nerve damage to the penis.

Fortunately, the barriers that once held back men suffering erectile dysfunction from seeking and receiving help are gradually breaking down. Public awareness initiatives, such as Andrology Australia’s recently launched ‘Talk About Your Tackle’ campaign,

Beware

improper care

The internet and billboards beside freeways are just two places where advertisements offering treatment for erectile dysfunction are commonplace. But the safety and effectiveness of such treatments are questionable and one commercial clinic that promotes unproven medications that have not been subjected to proper clinical trials is currently being investigated by the Australian Competition & Consumer Commission (ACCC).

Professor Robert McLachlan advises men seeking treatment for erectile dysfunction to use established medications that have been fully assessed, are clinically proven and prescribed by their doctor.

are encouraging men to recognise that they need help and that it’s okay to ask for it.

And, ultimately, men who have experienced erectile dysfunction and had it successfully treated are, in the words of Professor McLachlan, “very happy when they get their erections back”.

For more information about erectile dysfunction, visit www.talkaboutyourtackle.org or contact Andrology Australia by calling 1300 303 878 or visiting their website at www.andrologyaustralia.org wellplan > 11

Beating the

binge cycle

Many years spent battling binge eating disorder and bulimia spurred Carol Bull’s desire to help others overcome their own eating disorders.

WORDS JESSICA GADD PHOTOGRAPHY Jarrod barnes

member in focus

Binge eating disorder and bulimia, says former sufferer Carol Bull, consumes all your time, and before you know it, life is passing you by. Driven by a need to lose weight, she wasted years on restrictive diets that ultimately resulted in creating a diet binge cycle.

“There was no room for anything else,” the 55-year-old says. “I refused social invitations because I was worried about eating things I shouldn’t; I restricted my diet to avoid weight gain; I obsessed about food. It never occurred to me that I had more to offer the world than my appearance.”

Though the eating disorder emerged in her teenage years, which she spent in rural Australia, Carol was well into her 20s before she was able to identify it. It took years of self-exploration and counselling before she learned to identify the triggers – often emotional or just plain hunger – that sent her spiralling into a binge, and how to replace them with a new response behaviour.

“The best lesson I learned was to just sit with the feeling when it overcame me. I’d tell

“On Saturday morning I had an appointment with an oncologist, who arranged for me to go into hospital the next day. The test results were confirmed on the Monday and my treatment commenced on the Tuesday. I didn’t have to wait at all.”

After chemotherapy, Carol’s tumour had dramatically reduced in size but her weight had not. The medication’s unfortunate side effect of weight gain caused a brief slide back into binge eating and Carol underwent counselling again. But this time, it did not take long for her to recover from the relapse and today she’s focused on a healthy lifestyle.

“I look after myself very well, with fresh organic produce, a variety of exercise, meditation, yoga and a lovely drop of red in moderation.”

Carol’s lymphoma is not completely curable, so though the tumour is reduced, she maintains a vigilant watch on her health.

She says the health scare prompted her to pursue her interest in human behaviour, which had long been an unrealised dream.

Carol subsequently studied for a graduate

“As you move through the recovery process, the desire to binge becomes less and less. You wake up one day and realise it no longer has the hold on you that it had in the past.” myself ‘it’s just a feeling; it will pass’, and sure enough, it did,” says Carol.

Binge eating disorder and bulimia are most commonly experienced by young women in their late teens and early- to mid-20s, but men and older people can suffer from them, too.

In Carol’s experience, a lot of people with these disorders know a lot about nutrition and might even love to cook. She also identifies sufferers as perfectionists, seeking control over their body and their place in the world.

“At first, I didn’t want to stop,” says Carol.

“Food was such a comfort – I didn’t want the option taken away. But as you move through the recovery process, the desire to binge becomes less and less. You wake up one day and realise it no longer has the hold on you that it had in the past.”

Carol enjoyed many happy eating disorder-free years before a shock diagnosis with non-Hodgkin’s lymphoma, a cancer of the lymphatic system, in 2004.

“It was incredibly sudden – I felt off-colour, so I saw my doctor on a Friday morning and he sent me to have a scan that afternoon,” she says.

diploma of counselling and is now a member of the Australian Counselling Association. She works as a counselling therapist, specialising in helping people who struggle with binge eating and bulimia.

In the course of her work, Carol sees a lot of well-meaning people, such as friends and parents, who struggle to understand the disorder their loved one suffers. She says this anxiety can compound the problem and suggests that the best way to support somebody suffering from an eating disorder is to reassure them that they’re loved.

“Ask them, ‘What’s the best thing I can do for you?’. Hug, nurture and reassure them,” says Carol. “Learn as much about the disorder as you can and ensure the sufferer has a team of professional support, such as a GP, dietitian and counsellor. And look after yourself, too, because I see many parents run themselves ragged trying to help their child.”

Carol is determined to get the message out there that help is available, and she volunteers with Eating Disorders Victoria as a support group convenor and public speaker.

Carol Bull’s tips for coping with illness Don’t panic. Quickly seek professional help and find out what you’re dealing with.

Approach health holistically and be proactive about prevention and working towards optimal health. Open your mind to a range of options, such as meditation, yoga and Pilates.

Exercise – move, walk, bend, stretch, breathe. Feel life in your body.

Find medical practitioners who you trust. Developing these relationships is so important to your recovery.

Make use of your private health cover, which allows you instant treatment rather than being relegated to a waiting list (or if it doesn’t, upgrade!).

For more information, visit carolbullcounselling.com

“So many people tell me I’m the first person they’ve told that they have the disorder,” she says. “It’s sad to see people coping alone with isolation and fear – I remember what that’s like: the helplessness and loneliness.

“I’d like to emphasise that no matter what emotional issue you’re struggling with – food, alcohol, whatever – you don’t need to be alone with it. It is possible to move through it.” wellplan > 13

Equal opportunity There’s no need to be confused or worried by the offer of cheaper medicines when you have a prescription filled – a lower price does not mean lower quality.

WORDS Chris Sheedy

14 > wellplan

focus on

It’s common these days for a pharmacist to offer a cheaper generic alternative to a prescribed medicine. And while some may regard ‘cheaper’ as meaning ‘inferior’, the good news for consumers is that this is not the case.

In fact, the generic brands are no different to the original version of the medicine (the ‘originator’); they’ve just had to wait until the originator drug’s patent expired before their identical version could hit the shelves.

Dr Michael Tatchell, national director of health economics at the Pharmacy Guild of Australia, explains that when a drug company comes up with a unique medicine, they apply for a patent then begin a long and expensive process to test the drug and bring it to market. From the date of patent application, their investment is protected against competition for up to 25 years. This allows drug companies to recoup their development costs and make a profit, and also encourages them to continue spending money on innovation. Once the patent has expired, other generic versions of the medicine are allowed onto the market.

“Five or 10 years ago, there was quite a lot of scepticism about generic medicines,” says Dr Tatchell. “Now people are realising they are the same as the originator. The generics must meet all of the same stringent quality tests in order to be registered with the Therapeutic Goods Administration and be allowed on sale.

And choices will continue to increase as more and more drugs come off patent.”

Generic drugs, adds Dr Tatchell, were first introduced in Australia in the early 1990s. Originally, the pharmacist had to check with the patient’s doctor before offering the alternative brand but in the late 1990s, the guidelines were changed to allow pharmacists to use their professional discretion. These days, there might be many versions of a specific medicine when all generics are taken into account, but most pharmacists tend to carry the originator brand as well as one or two generic versions.

Generics now make up more than 30 per cent of medicines purchased in Australia.

TWO SIDES TO THE STORY

So, is there anything to worry about in swapping the originator with the generic?

Dr Steve Hambleton, president of the Australian Medical Association, says that only a few generics are not immediately interchangeable. If a very small change in dose may cause a significant change in the actions of the medicine then Dr Hambleton recommends some care in choosing alternatives. “Sometimes, if we need to get specific treatment exactly right for someone who has a history of being kept very stable by one brand, we will be hesitant to recommend any change,” he says.

“For instance, the consequences of instability can be devastating for epileptics. If you have a fit after three years of not having a fit, it means you can’t drive for six months.”

Dr Hambleton points out that most pharmacists will know immediately the drugs that should not be swapped, such as warfarin and drugs for epilepsy. As an added precaution, he notes that there is also a ‘Do Not Substitute’ check box on the prescription itself that the doctor can tick, which means that the pharmacist will not offer another brand.

The other cause for concern is potential confusion, says Dr Hambleton. One of his patients once took the originator medicine as well as the generic, thinking they were meant to be taken together, which led to serious illness. “The real danger is confusion, especially with elderly patients who are used to taking a specific tablet at a specific time,” he says. “By all means substitute the drug, but don’t double up and only take the recommended dose.”

Dr Hambleton says the best way to avoid confusion is to ask the pharmacist to pre-dispense the tablets for you. “There are several brands and types of pre-dispensers, and these simply mean that the tablets are placed into small boxes marked with the day and time they should be taken.”

The PBS safety net No matter what you might pay at the pharmacy, many medicines cost a lot more but are subsidised by the Australian Government’s Pharmaceutical Benefits Scheme (PBS).

Most medicines are on the PBS list and, generally, the maximum price for a single PBS medicine is $34.20 (or $5.60 for concession card holders), unless you choose, or your doctor specifically requests, a more expensive brand.

If you regularly buy medicines for yourself and/or your family, keep a tally on a Prescription Record Form (see your pharmacist). Once you reach $1,317.20 ($336 for concession card holders) – the Safety Net Threshold – ask your pharmacist for a Safety Net Card, meaning the most you will pay for the rest of the year is $5.60 per PBS medicine (free for concession card holders).

cost savings

In most cases, the generic version represents a significant saving. Dr Tatchell refers to a contraceptive pill originator brand that retails for more than $30 per pack and has a generic equivalent – the same product manufactured by a subsidiary company but retailed in different packaging – that costs about $17. Other examples include omeprazole (commonly used for reflux) that costs $3.56 more for the originator, pravastatin (for cholesterol) that costs roughly $3.80 more for the originator and sotalol (for cardiac arrhythmias) that costs about $4.75 more for the originator.

“The benefits of the cost saving are progressive,” says Dr Hambleton. “Over a period of time, as medicines are subjected to competition, the price comes down.

That is a good thing for Australia.”

wellplan > 15

eat well

Ironclad

nutrition

A staggering 80 per cent of the world’s population is estimated to be low in iron, making it the world’s most common nutritional deficiency.

WORDS EDWINA MCDONALD

Iron is an essential component of a healthy balanced diet. Its most vital function is to carry oxygen around the body but it also promotes a healthy immune system by helping white blood cells fight bacteria and is a key component of the muscle protein (myoglobin).

Despite all these important roles, iron is the most common nutritional deficiency worldwide1. As much as 80 per cent of the world’s population is iron deficient, while 30 per cent may have iron deficiency anaemia2,3. Being low in iron can present

Men 19–30 years 31–50 years 51–70 years Over 70 years

16 > wellplan

RDI (mg/day) 8 8 8 8

serious complications and lead to a condition called anaemia. Anaemia involves having less than optimal red blood cells in your blood so that insufficient oxygen is circulating. If you are low in iron, you may feel tired, fatigued, irritable and lack concentration.

Recommended dietary intake (RDI) values have been devised for use in Australia.

The RDI figures in the table below refer to the average daily iron intake needed to meet the nutritional requirements of nearly all healthy individuals4.

Women 19–30 years 31–50 years 51–70 years Over 70 years

RDI (mg/day) 18 18 8 8

Recipes and images from Jenny Craig Healthy Living For Families cookbook, Hardie Grant Books, $34.95rrp.

Food sources of iron

There are two types of iron found in food – haem and non-haem.

Haem iron is more readily absorbed by the body and is found in animal products, such as red meat, chicken, fish, eggs and offal products like liver or kidney. The body can absorb 15 to 35 per cent of the iron contained in animal products.

Non-haem iron is found in plant foods, some of which include broccoli, beans, nuts, dried apricots, peanut butter and iron-fortified cereals. The body typically absorbs 2 to 20 per cent of non-haem iron.

An individual’s iron stores have the greatest impact on the amount of iron the body absorbs. If an individual’s iron stores are low, their iron absorption will increase.

Non-haem iron absorption, in particular, is significantly affected by dietary intake, with certain combinations of foods playing an important part.

Consuming Vitamin C with non-haem iron sources makes it easier for the body to absorb the iron – for example, a glass of orange juice

with a whole wheat or iron-fortified cereal, red capsicum with a brown rice dish, or some tomato on multigrain bread with baked beans.

Cooking vegetables or legumes with meat can also increase the absorption of non-haem iron, even if the meat is not consumed.

Conversely, non-haem iron absorption can be inhibited by certain food combinations.

Inhibitors include caffeine (tea, coffee and cola drinks), large amounts of phytates (cereals, brans and green leafy vegetables) and soy proteins.

Calcium supplements should also not be taken at the same time as iron supplements as they compete for absorption.

How to boost your iron intake Include iron-rich foods at meals, such as red meat, offal and iron-fortified cereals.

Follow the Australian Guide to Healthy Eating and eat red meat three to four times a week; otherwise other foods high in iron will be needed.

To maximise absorption, combine non-haem sources of iron with foods rich in Vitamin C (for example, berries, orange juice, tomatoes, capsicum) or with foods containing haem iron.

Avoid drinking tea, coffee and cola drinks with your meal.

References: 1 ‘Iron Deficiency’, State Government of Victoria, Department of Health, http://www.health.vic.gov.au/nutrition/child_ nutrition/iron.htm 2 ‘Iron Deficiency Anaemia: Assessment, Prevention and Control. A guide for programme managers’, Geneva: World Health Organization, 2001 WHO/NHD/01.3 3 ‘Iron deficiency’, Digestive Health Foundation, 2008, www.gesa.org.au/pdf/booklets/ IronDeficiancyClinical.pdf 4 National Health and Medical Research Council (NHMRC) Nutrient Reference Values for Australia and New Zealand, 2006.

Vegetable stir-fry with prawns and cashews Nutrition tip: good source of iron, zinc and omega-3 fat Serves 4 6 cups mixed vegetables, cut into bite-sized pieces (a delicious combination includes zucchini, carrot, celery, asparagus, red and yellow capsicum, bok choy and snow peas) 3 spring onions, sliced into 4cm lengths 1 fresh chilli, finely sliced 1 garlic clove, finely sliced 1 teaspoon freshly grated ginger 1 small bunch coriander, roughly chopped 1 tablespoon salt-reduced oyster sauce 2 tablespoons salt-reduced soy sauce 3 tablespoons salt-reduced vegetable stock 1 tablespoon olive oil 500g raw prawns, peeled and deveined, tails intact ¼ cup cashew nuts 1. Place the raw vegetables in a large mixing bowl. Add the spring onions, chilli, garlic, ginger and coriander and toss to combine.

Drizzle oyster and soy sauce over the vegetables.

2. Heat a large wok over medium to high heat.

Add half the vegetable stock with the olive oil.

When steaming, add the prawns and cook for 2 minutes. Then add the vegetables and stir-fry quickly for 3–4 minutes or until cooked to your liking and the prawns are pink. Add more stock if needed. Scatter with cashews and serve with brown rice.

wellplan > 17

eat well

Moroccan carrot salad

Serves 4

Nutrition tip: good source of Vitamin C and iron

Salad ¾ cup quinoa 750g carrots, peeled ½ bunch radishes, washed and trimmed ½ x 400g can chickpeas, rinsed and drained 2 cups mixed herb leaves (eg, coriander, mint, parsley) ½ medium red onion, finely sliced 8 dates, sliced 2 tablespoons pistachio nuts, chopped 1. Place the quinoa in a fine strainer and rinse thoroughly with cold water.

Place in a saucepan with 2 cups of cold water and bring to the boil over high heat. Reduce the heat, cover and simmer for 12–15 minutes, until all the water has been absorbed. Set aside to cool.

2. Use a vegetable peeler or mandolin to slice the carrots and radishes into fine ribbons and place in a large bowl with the remaining ingredients.

Mix all ingredients together with dressing to serve.

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Dressing 1 orange, zest and juice 2 tablespoons lemon juice 2 teaspoons olive oil 2 teaspoons honey 1 teaspoon cumin, ground ½ teaspoon cinnamon, ground black pepper, to taste Place the orange zest and juice, lemon juice, olive oil, honey and spices in a bowl and whisk to combine. Season with black pepper to your liking.

SERVING TIP Quinoa is a seed that can be used in place of grains. When cooked, it has a fluffy consistency and a mild, delicate, nutty flavour. It is available in the health food section of the supermarket. If unavailable, use couscous or bulgur wheat instead.

eat well

Warm steak salad with asparagus and butter beans Nutrition tip: good source of haem iron, non-haem iron and Vitamin C Serves 4

Luscious lamb burgers Nutrition tip: good source of haem iron Serves 4

60ml balsamic vinegar 2 tablespoons wholegrain mustard 360g lean beef rump steak 1 punnet baby roma tomatoes, halved 1 large red onion, halved, cut into thin wedges olive oil spray ½ teaspoon chilli flakes black pepper, to season 1 bunch asparagus, woody ends trimmed, cut into 5cm lengths 1 x 400g can butter beans, drained ¼ cup fresh basil leaves, roughly chopped extra balsamic vinegar, to serve

1. Preheat oven to 200°C. Combine the vinegar and mustard in a shallow glass or ceramic dish. Coat the beef and cover with plastic wrap. Refrigerate for 30 minutes to marinate.

2. Line a large baking tray with non-stick baking paper. Place the tomatoes and onion on the tray and spray with olive oil spray.

Sprinkle with the chilli flakes and season with pepper. Roast in the oven for 20–25 minutes, until the tomato is tender.

3. Boil the asparagus for 2–3 minutes or until bright green. Refresh under cold running water and drain. Place the asparagus and butter beans in a large bowl.

4. Spray a grill pan with olive oil spray and preheat on high. Grill the beef for 2–3 minutes on each side (for medium) or until cooked to your liking. Remove from the heat and wrap in foil to rest for 5 minutes.

5. Toss the tomato/onion mixture with the asparagus/beans, mix in basil and divide onto plates. Thinly slice beef across the grain and place on top of the salad. To serve, drizzle extra balsamic vinegar over the beef.

550g lean lamb mince 2 tablespoons brown shallots, finely chopped 1 egg, lightly beaten 2 tablespoons fresh mint, chopped 2 tablespoons fresh parsley, chopped 2 tablespoons oregano, dried cracked black pepper 1 large beetroot, washed, peeled and leaves removed 2 large carrots juice of 1 lemon 1 teaspoon olive oil 2 tablespoons chives, chopped 3 teaspoons tahini ½ clove garlic, minced ¼ cup low-fat Greek-style yoghurt 4 wholegrain hamburger buns, halved and toasted 50g rocket leaves 1. Preheat the oven to 180°C. Place the lamb, shallots, egg, chopped herbs and oregano in a large bowl. Season with pepper and combine well. Using your hands, shape the mixture into four even patties. Cover and chill for 10 minutes.

2. Use a large box grater to coarsely grate the beetroot and carrot. Place in a bowl and add the lemon juice, oil and chives. Toss to combine.

3. In a small bowl, combine the tahini, garlic and yoghurt (can be made ahead of time, in which case cover and chill).

4. Heat a non-stick frying pan over medium heat. Cook the burgers for 2 minutes on each side, then place in the oven for a further 5–6 minutes to finish cooking.

5. Dollop some tahini yoghurt sauce on each bun, top with rocket and a lamb burger, then finish with the carrot and beetroot salad.

wellplan > 19

Viva

la resistance!

A growing amount of research shows that strength training has an anti-ageing effect – and it has a whole lot of other benefits, too, for all age groups.

WORDS Thomas Walker

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Live well

No matter what your age, exercise is a vital factor in maintaining a healthy lifestyle. One form of exercise that reaps enormous benefits, especially as we grow older, is strength or resistance training. But what is it and how easily can it be incorporated into our daily lives?

Strength or resistance training is any movement that requires the use of our muscles to oppose a resisting force. Generally, it should be undertaken every two or three days as part of a healthy lifestyle1. And the good news is that you don’t need to seek out a specially equipped gymnasium – thousands of Australians undertake safe, credible strength programs in their own homes, the office, a local park or swimming pool.

Why is strength training important?

There are benefits for all age groups in promoting healthy, lean muscle in our bodies.

The amount of lean muscle we naturally carry is largely affected by age and genetic factors; however, research shows that strength training can greatly improve it2.

Many people would love to look in the mirror and see a lean athletic figure. But the benefits of resistance training are much more than skin deep – studies show that people who undertake regular strength training report better quality of life, a less depressed mood, improved circulation, lower blood pressure and greater muscle strength, making everyday tasks much easier3.

Poor sleeper? A recent study links improved sleep quality with resistance training due to an increase in the growth hormone released as we rest4. This hormone, which is stimulated by strength training, helps to strengthen bones and repair muscles while we rest and is seen to promote a more reliable and restful sleep in the process.

Another benefit centres on weight, more particularly fat loss. Resistance training increases fat-free mass and this change in body composition enhances fat loss5. Fundamentally, more muscle and less body fat results in an effective way to prevent and manage chronic disease.

Chronic lower back pain patients report improved pain outcomes, increased spinal mobility and improved overall function.

Similarly, diabetics showed improvements in glycaemic (blood glucose) control, and resistance training is viewed as a preventative action against developing diabetes6.

Resistance training is also conducive to bone health. Our bones stop ossification (hardening) around the age of 20 to 25 and women, in particular, can experience a rapid loss of bone mineral density after menopause.

However, like the skin, bone constantly replaces itself throughout our life and to stimulate this regeneration, we must place a suitable load on our bones and joints.

Weight-bearing exercises and resistance training, along with regular walking, are considered essential components in slowing the loss of bone density7 and helping to prevent the onset of diseases like osteoporosis.

Studies also show a healthy amount of lean muscle will reduce the onset of sarcopenia, a term for the decline of muscle mass and strength with age8. Sarcopenia contributes to our feeling and appearance of being ‘old’ or ‘frail’, so limiting its development by rejuvenating old and damaged muscle tissue with weight training can help keep our bodies feeling younger for longer.

References: 1 American College of Sports Medicine Position Stand on Progression Models in Resistance Training for Healthy Adults.

Med Sci. Sports Exerc. Vol. 34, No. 2, 2002, pp. 364-380 2 Tarnopolsky M et al, (2007), Gene expression, fiber type, and strength are similar between left and right legs in older adults, Journals of Gerontology A: Biological Sciences & Medical Sciences, Oct;62(10):1088-1095, http:// biomed.gerontologyjournals.org/ 3 Selig et al, (2004), ModerateIntensity Resistance Exercise Training in Patients With Chronic Heart Failure Improves Strength, Endurance, Heart Rate Variability, and Forearm Blood Flow, Journal of Cardiac Failure Vol. 10 No. 1 4 Ferris et al, (2011), Resistance Training Improves Sleep Quality In Older Adults – A Pilot Study, Advances in Preventive Medicine, Volume 2011 (2011), Article ID 984683, 7 pages doi:10.4061/2011/984683 5 Donnelly JE et al, (2004), American College of Sports Medicine Position Stand.

Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Journal of Cardiac Failure Vol. 10 No. 1 6 Kujala UM.(2009) Evidence for exercise therapy in the treatment of chronic disease. Br J Sports Med 43:550–555. doi:10.1136/ bjsm.2009.059808 7 Chilibeck, M. J. Chrusch, K. E. Chad, K. S. Davison, and D. G. Burke, (2005), Creatine monohydrate and resistance training increase bone mineral content and density in older men, Journal of Nutrition, Health and Aging, vol. 9, no. 5, pp. 352–355 8 Tarnopolsky M et al, (2007), Gene expression, fiber type, and strength are similar between left and right legs in older adults, Journals of Gerontology A: Biological Sciences & Medical Sciences, Oct;62(10):1088-1095, http:// biomed.gerontologyjournals.org/

Accredited Exercise Physiologists (AEPs) are degree-qualified allied health professionals who specialise in the delivery of exercise and lifestyle modification programs to suit a wide range of people, including those with chronic conditions. You can locate an AEP near you by phoning the national Exercise & Sports Science Australia (ESSA) office on (07) 3856 5622, or by visiting their website at essa.org.au.

If eligible, you can claim on visits to AEPs who are registered with Medicare Australia/DVA or WorkCover through a GP referral. Speak to your GP to see if you are eligible for a referral. Australian Unity recognises exercise physiology services and provides benefits for people on the right cover*. * Exercise Physiology benefits are not available on Basic Extras, Smart Start, Smart Combination or Overseas Visitors Cover.

Swing into

action

Accredited Exercise Physiologist (AEP) Thomas Walker lists some basic lowimpact strength exercises that you can perform at home. Try 8–15 repetitions and three sets of each exercise every two to three days and make sure you alternate between arm and leg exercises in one session. Importantly, any movement should be controlled and balanced and not cause sharp pain. And always check with your GP first to make sure these activities are suitable and safe for you.

Wall push-ups: stand about a metre from a wall with your hands outstretched, then lean towards the wall and gently push back until in a standing position again.

Push-ups on your knees.

Calf raises while sitting: point your toe and squeeze your calf for 15 seconds.

Calf raises while standing: bend your knee and raise your heel up behind you as far as possible before lowering – you may need to hang on to something for stability.

Leg raises: lying flat, raise and lower one leg at a time.

Arm exercises: bicep curl or overhead press, using any type of weight (including household items) and sitting or standing.

Sit-ups: abdominal sit-ups lying on your back.

Step-ups: step up and down onto a step, alternating the starting leg.

Wrist exercises: squeeze a foam ball or firm pillow to increase hand and wrist strength.

wellplan > 21

AUSTRALIAN UNITY & YOU

Member benefit

Tiered Medicare Levy Surcharge and rebate proposal What does it mean?

The Federal Government’s proposal to introduce a tiered Medicare Levy Surcharge (MLS) threshold and means-tested Private Health Insurance (PHI) Rebates has gained momentum. The legislation is expected to come into effect in late 2011 or 2012.

The proposed changes are summarised below: The MLS is likely to remain at 1 per cent. However, the PHI Rebate for singles who earn $80, 001 or more (or for couples, $160,001), will be 20 per cent for those aged up to 65 years, 25 per cent for those over 65 years and 30 per cent for people over 70 years.

Tier 1:

The MLS is likely to increase to 1.25 per cent. For singles who earn $93,001 or more (couples $186,001), the PHI Rebate will be 10 per cent for those aged up to 65 years, 15 per cent for those over 65 years and 20 per cent for those over 70 years.

Tier 2:

Tier 3:

Member benefit

The MLS will be increased to 1.5 per cent. For singles who

earn $124,001 or more (couples $248,001), no PHI Rebate will be provided.

A recent report found that means testing the 30 per cent Rebate on Private Health Insurance could push as many as 1.6 million Australians out of the private health system and into the public sector over five years.

This would put increased pressure on the public hospital system, with an estimated 845,000 or more additional treatments being required as people exit private cover1. Additionally, it is expected another 4.3 million Australians will downgrade their hospital cover.

Australian Unity will keep members informed about how the legislation will apply to them if it is passed.

For more information, keep an eye on the Australian Unity website or visit privatehealth.gov.au/healthinsurance/ incentivessurcharges/mls.htm

References: 1. The report, Economic Impact Assessment of the Proposed Reforms to Private Health Insurance, (commissioned by the AHIA in 2011) was conducted by Deloitte and based on ANOP/ Newspoll research of 2,000 Australian households.

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with direct debit By using direct debit to pay your Australian Unity premiums, you not only save time and effort but also money! When you set up a direct debit with your nominated bank,

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Finger

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pulse

Regular check-ups with your GP are all part of a good health regime and help you to monitor simple but important factors like your blood pressure and waist size.

At Australian Unity, we like to encourage our members to maintain optimum health, so we will give you up to $150 per person per calendar year for recognised health checks performed by a doctor in private practice when not covered through Medicare*.

Visit australianunity.com. au/wellnessbenefits to find out more. *Available on all Hospital and Combination Covers except Care ’n Repair and Overseas Visitors Cover.

building society, credit union or credit card account, you’ll save 4 per cent off the standard premiums rates*.

To set up your direct debit payment, call us on 13 29 39 and we’ll arrange everything over the phone, or simply login to australianunity.com.au/onlineservices and click through to ‘payments’ to update your payment details. *Not available on Overseas Visitors Cover.

AUSTRALIAN UNITY & YOU

Calling all

Ee-Wynn Lee Participants in Australian Unity’s Remedy Healthcare programs may already know of dietitian Ee-Wynn Lee’s passion about health and nutrition, chronic disease management, medical nutrition therapy… and chocolate ice cream!

Tell us about your role at Australian Unity.

I am a dietitian at Australian Unity, largely helping members to understand and manage health conditions with medical, nutrition and lifestyle advice. I currently run three programs, including the Bone Health Program, the Diabetes Program and the Coronary Artery Disease Program. These programs assist members to manage and improve their health with telephone-based advice and support. I identify and contact members who might benefit from these programs, provide nutritional and lifestyle advice, update individuals on the best way to manage their condition and, where appropriate, refer members to programs and services in their local community.

What are the differences between a dietitian and a nutritionist?

Nutritionists usually provide more general health and nutrition advice,

whereas dietitians also work in chronic disease management and specialise in medical nutrition therapy.

How can a dietitian help an average healthy person?

Dietitians are trained in behaviour modification and motivational interviewing techniques, which can help you to overcome barriers and make changes to unhealthy behaviours. We also provide support and advice on how to make the right choices when it comes to healthy eating and exercise.

If you could only eat one meal for the rest of your life, what would it be?

I‘d have to say my dad’s homemade hearty vegie soup. It’s a real comfort food for me and I would be quite content to eat it every day for the rest of my life.

What is your favourite ‘treat’ food and how often do you eat it?

Chocolate ice-cream is my weakness!

Contrary to stereotypes, dietitians do eat junk food. However, I try to practise what I preach and follow the 80/20 rule. So 80 per cent of the time I try to eat healthily and the other 20 per cent ... ice-cream time!

cover stars Do you have an interesting story to tell?

wellplan is on the lookout for Australian Unity members to feature on our front cover, and it could be you! If you have a health or life story that you think other members might like to hear about, we want to hear from you.

Cover-featured members are interviewed by a journalist, have their hair and make-up done by a beauty stylist, and are photographed by a professional photographer.

So, what are you waiting for?

It’s not often you get a chance to appear on the front cover of a magazine! Write to us at wellplan@australianunity.com.au or wellplan, Front Cover Story, Reply Paid 64466, South Melbourne, Victoria 3205 (no stamp required).

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understanding your cover

Time

to take

cover In 2010, Lifetime Health Cover marked its 10-year anniversary.

But what exactly is this government initiative and, more importantly, does it affect you?

WORDS LORISSA NORD

Turning 30 means different things to different people. To some it means mortgages and starting families, to others it’s the perfect time to take the trip they’ve been dreaming of. But for most people, it’s a good time to take out hospital cover – if they haven’t already – because those who don’t may be affected by Lifetime Health Cover.

What is Lifetime Health Cover?

Lifetime Health Cover (LHC) is a financial loading on your private health insurance hospital cover. It is a government initiative aimed at encouraging people to take out and maintain hospital cover – not just extras cover.

Do I have to pay LHC? If you took out hospital cover before July 1 following your 31st birthday and you haven’t let it lapse then you don’t have to pay the LHC loading. However, if you haven’t taken out private hospital cover by this date, when you do decide to purchase hospital cover later in life, on top of the standard premium you will pay an extra 2 per cent for every year that you were without cover over the age of 30 (to a maximum loading of 70 per cent). For example, if you take out hospital cover when you are 42 years old, you will pay an extra 24 per cent (2 per cent x 12 years) on your 24 > wellplan

health insurance payments. If you are a recent migrant to Australia, you have 12 months from your registration with Medicare to sign up for hospital cover before the LHC loading applies.

Accounting for gaps in hospital cover The LHC does allow for gaps in your hospital cover of up to nearly three years (1,094 days) during your lifetime without affecting your loading*. So, for example, if you changed over to Australian Unity hospital cover and you had a gap period of four months without insurance, you wouldn’t have to pay the LHC loading – as long as your previous combined gaps without cover weren’t greater than 1,094 days in total. You will, however, need to provide Australian Unity with your transfer certificates from all your previous health funds as proof of continuous cover or to enable us to accurately calculate your LHC loading. Your previous health fund should be able to send you a copy of your transfer certificate within 14 days of your request.

Here’s the good news…

In 2007, the Australian Government introduced a 10-year cap on paying the LHC loading. This means that if you maintain continuous hospital cover for 10 years – regardless of whether you change health funds during this time – your LHC loading will be removed. This will happen automatically on your 10-year anniversary of paying LHC, as long as you have provided Australian Unity with all your transfer certificates (if applicable) and you continue to maintain your hospital cover.

To find out more about Lifetime Health Cover and how it affects you, call us on 13 29 39 or visit australianunity.com.au/lhc * Waiting periods still apply. Medicare Levy Surcharge is not exempt for any gap in hospital cover.

wellplan rewards

Wellplan Rewards

®

In addition to great-value Hospital and Extras Cover, Australian Unity membership comes with additional benefits… subscribe to Wellplan Rewards and take advantage of the following exciting offers.

RedBalloon

There’s no excuse to be bored. With $30 off selected RedBalloon experiences, you could get the adrenalin pumping in a V8 racing car or jet fighter plane, enjoy the great outdoors by bungy jumping, or simply lay back and relax with any number of pampering options.

Why not share the love and give someone a magical experience as a gift? Choose from the following categories: • Driving – V8 racing, classic car hire, rally driving, go-karting • Flight and Flying – learn to fly, helicopter and scenic flights, hot air ballooning, jet fighter flights • Gourmet – cooking classes, wine tasting, personal chef • Outdoor – bungy jumping, horse riding, abseiling • Spa and Wellbeing – pamper, beauty/fashion consultation • Water – jet boating, kayaking, scuba diving • Getaways – romantic, relaxing, adventure

Gone are the days of locked-in contracts, being restricted to one fitness club or a small chain and paying extra to use a gym outside your area. Our Passport holders can access any of the services offered by the participating health clubs, gyms or fitness centers in the Passport2Fitness network with the simple swipe of a finger.

Participating clubs offer a range of services such as gyms, Yoga and Pilates, rock-climbing walls, swimming, squash, tennis, outdoor group training and more. With over 80 clubs across Australia, you’ll find one near you with the services you seek. With a Passport, members get full access to all clubs in the network that are rated at or below the level of their passport. For instance, Gold Passport members can access Bronze, Silver and Gold Clubs whereas a Silver Passport allows access to Bronze and Silver Clubs. Please search our club locator to determine which club best suits your needs.

* Passport membership is only available by signing up online and is not available from any Passport2Fitness Partner Clubs. Walk-up or in-store applications will not be accepted by the individual clubs. Not to be used in conjunction with any other offer.

My Rewards Cruises

Save $200 on 13- and 14-night New Zealand cruises* Into the sea, you and me… set sail from Sydney, Melbourne or Brisbane on a 13- or 14-night Princess Cruise to New Zealand on the Dawn Princess, Sun Princess or Sea Princess between November 2011 and March 2012 and pay $2,599 pp instead of $2,799 pp*.

Plus, book by October 15, 2011, and receive a complimentary upgrade from Outside Twin Share to Balcony Cabin category.

Go to: australianunity.com.au/wellplanrewards Search for: My Rewards Cruises For more information: phone 1300 180 420

Go to: australianunity.com.au/wellplanrewards Search for: RedBalloon For more information: redballoon.com.au *Terms and conditions apply to the use of the RedBalloon Australia website found at redballoon.com.au.

A discount of 25% on a complete pair of prescription glasses, or a free pair of prescription sunglasses with every purchase of complete spectacles*. This includes a free retinal photograph (valued at $90)

10% discount on a month-to-month membership and no joining fees (usually $99.95) on any monthly Passport*

Go to: australianunity.com.au/wellplanrewards Search for: Passport2Fitness For more information: passport2fitness.com.au

Receive $30 off a selected range of RedBalloon experiences available online*

Eyecare Advantage

Passport2Fitness

*Selected sailings only. Price is per person based on a twin share cabin and includes government fees and taxes. Please call 1300 180 420 to hear the full terms and conditions.

In addition, members with Extras can enjoy optical benefits of between $150 and $300 per year (depending on the level of cover). So, with this exclusive offer from Australian Unity’s preferred optical store, Eyecare Advantage, don’t put off that visit to the optometrist.

Go to: australianunity.com.au/wellplanrewards Search for: Eyecare Advantage For more information: eyecareadvantage.com.au *Available to members with Extras Cover only. Not to be used in conjunction with any other offer.

The free pair of prescription sunglasses is from a selected range only.

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magazine Did you know you have the option to view wellplan magazine online? Access to useful health and lifestyle information is now just a click of a button away – and by choosing not to receive the print version, you’ll be helping the environment by cutting down on paper waste while you’re at it.

Simply go to australianunity.com.au and login to Online Services. Within the ‘My Membership Details’ section, choose ‘Manage your communication preferences’, and from here select to receive wellplan magazine via email. When the next edition of the magazine is produced, we will send you an email with a link to access wellplan magazine online.

If undelivered please return to: Locked Bag 650 Clayton South Vic 3169

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