Wellplan - Issue 21_1

Issue 21 > SPRING 2012

Time out Playing it smart in the sun

Bon appĂŠtit Classic and simple recipes from Bill Granger on page 18

Fire in the brain

Recognising the signs of stroke

Alcohol proof

Why young brains and drinking don’t mix

Inside 1 Welcome 2

Your Say Letters and Ask Our Expert

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Australian Unity & You Information about member benefits, changes to the Australian Government Rebate on private health insurance, staff Q&A, plus competitions and reader survey

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Know Your Cover Quit smoking

7

Know Your Cover Wellness for Everyone

8

Spotlight On Signs of stroke

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Understanding Your Cover Saving lives through first aid

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10 Expert Opinion Alcohol and adolescents 12 Member In Focus Steve Badger 14 Facts On Oral health 16 Focus On The effects of the sun 18 Eat Well Balancing your diet

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22 Live Well Taking care of your feet 24 Hot Topic Heart disease 25 Rewards Additional member benefits

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Welcome At Australian Unity, we like to know what our members are thinking, and throughout this issue of wellplan you’ll find opportunities to share your opinions and thoughts. If there’s a topic you want to know more about, let us know and we’ll do our best to cover it within our next issue, or if you have an interesting health-related story to tell, we’d love to hear it. And, just by signing up to receive wellplan electronically or completing our reader survey, you’ll go into the draw to win some fantastic prizes, including a $1,000 travel voucher.

In addition to our bounty of giveaways, this issue of wellplan investigates the fundamental health concerns that we believe you should know about. Given that stroke is the second most common cause of death in Australia, we’ve included an easy-toremember strategy from the National Stroke Foundation to help you identify the warning signs – see our feature on page 8.

Also in this issue, we look at the connection between your oral and overall wellbeing and the damaging effects of alcohol

Contributors DR GENEVIEVE YATES This issue’s ‘Ask Our Expert’ is Genevieve Yates, a GP and medical educator from Ballina, NSW. She complements her work with a range of creative writing and acting pursuits and is a regular columnist for the medical newspaper, Australian Doctor.

KIMBERLY GILLAN

on adolescent brains – a strong argument for deterring young people from drinking for as long as possible.

And, mindful that many people are affected by skin cancer and heart disease each year, we’ve provided useful information to help you prevent – or combat – these conditions.

These articles and many more will hopefully give you and your family some useful tools to help you stay healthy and get the best out of life.

Amanda Hagan Chief Executive Officer – Healthcare

Kimberly Gillan is a Melbourne-based freelance journalist who writes about nutrition, exercise and mental health for a range of publications, including Body + Soul, Marie Claire and Weight Watchers. Kimberly explores the issue of alcohol and adolescents on page 10.

JESSICA GADD Jessica Gadd is a freelance journalist who has edited several health magazines and written extensively on a variety of health issues in both Australia and the UK. On page 14, she examines the links between oral health and overall wellbeing.

CHRIS SHEEDY

AWARD WINNING HEALTH INSURANCE 2009

Freelance writer Chris Sheedy’s strong interest in health and fitness has seen many of his features appear in publications such as Body + Soul, GoodMedicine and Men’s Fitness. Chris walks us through the importance of good foot care on page 22.

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

wellplan > 1

your say

Letters Winning letteR My husband and I welcomed our second child eight weeks ago. Unlike the first time around, this time we were eligible to sign up for Australian Unity’s baby+me® program – and we were so glad we did!

Reading the baby+me article in your last issue of wellplan (issue 20), I couldn’t agree more in terms of the benefits this program provides. The calls, emails and practical advice were, and continue to be, of great value. The assistance has not just been for our baby, but also provided practical advice on juggling the parenting of a newborn with a 22-month-old sibling.

If you’re eligible, I highly recommend you sign up if you’re expecting – and if you are thinking of conceiving, upgrade your membership to make sure you’re eligible!

Thanks again for a great program and for the article outlining the benefits in wellplan.

R. Libinaki, Chadstone, VIC

Second opinion I read with interest the article about Liz Smart’s experience with colon cancer (wellplan issue 20).

My experience is quite different. I went to the doctor asking for a referral for a colonoscopy and was asked, “why would you want to put yourself through an anaesthetic at your age?” and was given a Faecal Occult Blood Test (FOBT) kit. This subsequently came back with a negative result.

If I wasn’t so in tune with my body and felt that I had bowel cancer, I would not be here now. I eventually consulted another doctor and demanded a referral for a colonoscopy, which confirmed my belief.

write & WIN

Exploring other options I always look forward to reading wellplan magazine and the Autumn 2012 issue was no exception. I particularly enjoyed the article ‘Natural Progression’ about alternative therapies.

I feel that, as a society, Australians are becoming increasingly aware that although conventional medicine can assist with a vast array of health issues and save lives, there are other health options out there. These alternative treatments can be effective in their own right, in parallel

I want to mention an article that appeared in the April 2010 edition of the Women’s Weekly. It pointed out that 30 percent of FOBTs return a false negative (as in my case). The article also went on to say that people over 60 years of age should have a colonoscopy every two to three years.

My intention here is to bring attention to the fact that an FOBT is not necessarily the Holy Grail. Yes, it picks up 70 percent but not 100 percent!

P. Johns, Kangaroo Flat, VIC Note from the editor: While the FOBT does not guarantee a 100 percent accurate reading, it is a useful tool in detecting early-stage bowel cancer. Since Liz Smart’s interview appeared in wellplan, the Federal Government has expanded the National Bowel Cancer Screening Program, offering a free test to people turning 60 on or after January 1, 2013 – joining those aged 50, 55 and 65 already in the program, who hold a Medicare card or DVA gold card. People aged 70 will be added in 2015 and from 2017–2018 the program will be incrementally expanded to include screening for all Australians aged 50–74 every two years.

For those ineligible for the free test kit, there are other options available. Visit letsbeatbowelcancer.com to find out more.

We’re always interested to hear what you think, and there are some fabulous prizes up for grabs for members who share their thoughts on this issue of wellplan, or tell us about a health and wellbeing experience that has inspired you, or just let us know about something that’s important to you.

Most of all, we just want to hear from you.

The author of this issue’s winning letter has won a third-generation 16GB iPad with

with mainstream medicine or when mainstream medicine has not been able to help.

Your overview of some of these complementary health choices may encourage some people to think about alternative treatment options that they may not have previously considered. One of the reasons I remain with Australian Unity is because of the benefits it pays for a wide range of natural therapies.

Personally, I love my acupuncturist just as much as my family GP! K. Delbridge, Burwood, VIC

New beginnings My husband and I recently decided to get private health insurance. We chose Australian Unity because we found it was the most affordable, and the extras package included exactly what we needed.

As a young person not knowing much about private health insurance, I found it very easy to sign up. I did it online and within a matter of minutes we were covered. If I had any questions, they were more than willing to help. Our cards and additional information arrived only days later in the post, including wellplan, which is easy to read and has some interesting articles.

I look forward to the future and what it may bring and I am confident that my health fund will be there with us every step of the way. Thank you Australian Unity.

T. Gough, Griffin, QLD

Wi-Fi, $539rrp, while the authors of the other published letters in the ‘Your Say’ and ‘Ask Our Expert’ sections have received a copy of Bill Granger’s Bill’s Basics cookbook, $49.99rrp, along with a $50 Rebel Sport voucher.

Simply email your letters to wellplan@ australianunity.com.au or mail them to wellplan, Your Say, Reply Paid 64466, South Melbourne, VIC 3205 (no stamp required).

Please note that published letters may be edited.

Ask Our Expert This issue’s questions have been answered

by Dr Genevieve Yates, a practising GP and medical educator based in the Northern Rivers area of New South Wales.

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 have heard a lot in the media recently about the dangers of statin medications. My doctor has suggested I take one for my cholesterol but I am a bit worried about the side effects. What should I do?

N. T., Southbank, VIC Statin medications are the most widely prescribed drugs in Australia and are very effective at lowering cholesterol levels.

They have been proven to significantly reduce the risk of heart attack and stroke, especially in people who have other risk factors, such as high blood pressure, diabetes and a personal or family history of cardiovascular disease.

Most people who take a statin medication have no, or very minor, side effects. However, statin medications are associated with rare but serious side effects, including severe muscle inflammation and liver problems, and recent research has suggested that statins may increase the risk of diabetes and dementia in some people.

As with any medication, the potential benefits and risks need to be weighed up by each individual, in conjunction with their doctor.

Regardless of whether cholesterollowering medication is taken or not, there are lots of non-drug ways to help manage your cholesterol.

Check out the Heart Foundation’s website heartfoundation.org.au for some great tips.

Coconut oil seems to be getting a lot of attention recently, thanks to its many health benefits – assisting with weight loss and maintaining healthy cholesterol levels, increasing immunity, improving digestion and kidney function – as well as its antifungal and antibacterial properties. I absolutely love anything coconut, so this sounds like good news to me! Plus, I’m told that even though it’s a saturated fat, it’s a good one because it contains medium-chain fatty acids. Can you tell me, is it really as good as it is made out to be?

L. Sayer, Ferntree Gully, VIC Just like the ads for Castrol have told us for decades, “oils ain’t oils”.

Fish oil has been the teacher’s pet and top of the class for a while now, while trans fat is standing in the corner in disgrace and lard has been in detention for years.

Oils such as coconut have report cards that read “competency unclear”.

Coconut oil has a saturated fat content of around 90 percent. In general, saturated

I’m a 77-year-old male, weigh 56kg and am 168cm tall. I exercise daily by playing golf and tennis and going to the gym. My yearly blood test is good, only my blood glucose levels have been up and down these past few years, ranging from 5.4 to 6.4 millimoles per litre (mmol/L) – though mostly staying around 5.6 to 5.8mmol/L – and my GP advises me to take a glucose tolerance test. However, I’m hesitant to go for a test because, in Queensland, the recommended blood glucose target range is 3.6 to 6.0mmol/L and in New South Wales it’s 3.3 to 5.5mmol/L – and my blood glucose level is mostly still below 6.0mmol/L. I always eat low-GI food, fruit and vegetables, brown or basmati rice and wholegrain bread. What advice can you give me?

D.K., Rose Bay, NSW It sounds as though you’re doing all the right things to keep your blood sugar down: regular exercise,

fat is considered to be very unhealthy and dietary guidelines suggest avoiding it whenever possible. It is true that, unlike most other saturated fat-rich foods, coconut oil is mostly made up of medium-chain fatty acids (MCFAs), which are more easily absorbed and digested by the body, but robust evidence for coconut oil’s purported health benefits is currently lacking1.

Society has an insatiable appetite for foodstuffs that supposedly promote weight loss, boost energy and improve wellbeing.

‘Miracle’ products come and go – their claims almost invariably not standing up to scrutiny over time.

Short-term use of coconut oil, taken in moderation, is very unlikely to cause you harm but there is no guarantee it will be of any benefit. To achieve long-term weight loss, nothing has been shown to work better than to ‘eat less and move more’.

maintaining a healthy weight and eating a balanced, low-GI diet. Well done!

Unfortunately, there are factors out of your control, such as age and genetics, which play a large part in the equation.

I agree that it is confusing when labs use slightly different reference ranges. I use the guidelines put out yearly by Diabetes Australia2, which state that a normal fasting blood glucose reading is under 5.5mmol/L and a reading of 7.0mmol/L or above is likely to be diabetes. Levels between 5.5 and 6.9mmol/L are the tricky in-between ones.

In order to determine if diabetes is present, an oral glucose tolerance test (OGTT), in which a sugary drink is given and blood is taken initially and then one and two hours afterwards, is recommended for patients who, like yourself, have borderline blood-sugar readings. I think an OGTT will provide you and your doctor with valuable information regarding your risk of diabetes and is an easy and (relatively) painless exercise.

References: 1 mayoclinic.com/health/coconut-oil-and-weight-loss/AN0189 2 Diabetes Australia and The Royal Australian College of General Practitioners, ‘Diabetes management in general practice’, 17th edition, 2011/12, p.9.

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AUSTRALIAN UNITY & YOU

A clearer picture Important changes... to the Australian Government Rebate on private health insurance.

The Australian Government Rebate on private health insurance is now income tested. The amount of rebate you receive on your health cover is dependent on income as well as age. The Medicare Levy Surcharge, an additional tax on individuals who earn over $84,000 and do not have private hospital cover, has also increased.

At Australian Unity, we recognise that good eyesight is precious and, as 80 percent of blindness and vision impairment globally is preventable by early detection1, we believe it’s important to have your eyes tested regularly, especially as you get older.

Australian Unity Extras cover makes it easy for members to do this by providing generous optical benefits, with limits renewing on January 1 each year.

Members with Extras can enjoy, depending on the level of cover, optical benefits of between $150 and $300 per

Member benefit

year, as well as access to exclusive offers with Eyecare Advantage, such as:

25 percent off a complete pair of prescription glasses; or a free pair of prescription sunglasses with every purchase of complete spectacles.

So, keep a close eye on things with regular optometry appointments and, when you’re planning your next checkup, visit Australian Unity’s preferred optical store, Eyecare Advantage.

To find out if you’re impacted by the changes, visit australianunity.com.au/rebate, where you can access our simple, useful online calculator to help you determine your rebate tier.

For more information or to make a booking, visit australianunity.com.au/eyecareadvantage or call 1300 709 033.

Full details on benefits available under your level of cover can be found by logging into Online Member Services at australianunity.com.au/memberservices or by calling 13 29 39.

You can update your rebate tier anytime via Online Member Services or by calling 13 29 39.

Reference: 1 World Health Organization (1997), ‘Blindness and Visual Disability Part II of VII: Major Causes Worldwide’, Fact Sheet No 143.

WIN! • WIN! •

• WIN! • WIN!

$1,000

Take our survey and win a $200 gift card!

flight voucher!

Sign up to receive wellplan magazine electronically by 30 September 2012 and you’ll go into the draw to win a $1,000 Flight Centre travel voucher!

All the latest health news and insights from Australian Unity are now just a mouse click away – plus, you’ll be helping the environment by cutting down on paper waste.

Simply login or register for Online Member Services at australianunity.com.au/ memberservices. In the ‘My Membership Details’ section, you can choose ‘Manage your communication preferences’, and select to receive wellplan magazine via email.

For competition terms and conditions, go to australianunity.com.au/wellplantcs

4 > wellplan

Here’s your chance to tell us what you think of wellplan! We’re interested in your opinion and are always looking for ways to improve our magazine to ensure it reflects what you most want to read about. And to thank you for completing our survey, you’ll go into the draw to win one of five $200 gift cards*.

So, go to australianunity.com.au/ wellplansurvey and let us know your thoughts by 30 September 2012. *For competition terms and conditions, go to australianunity.com.au/surveytcs

$2 0

0

Member benefit

Screen saver Breast cancer is the second most common cause of cancer-related death in Australian women1. In recognition of this, there is a variety of programs in place to boost awareness of the disease; the Cancer Council runs the annual Pink Ribbon Day for this purpose, as well as to raise funds for research, early detection and patient support programs.

In addition, the Australian Government provides free bi-yearly screening mammograms for Australian women aged 50–69 as part of its BreastScreen program.

While screening mammograms are primarily recommended for this age bracket, women aged 40–49 are still at risk of breast cancer1 and are also eligible to have a free breast screening mammogram with BreastScreen every two years.

For those members who do not meet the age requirements specified by BreastScreen but would still like to get checked out, depending on your cover, Australian Unity offers a 70 percent benefit on the cost of a screening mammogram*. To claim, just send a copy of the receipt for your screening mammogram, together with a completed claim form, to Australian Unity. *Available on LifeChoice and LifeChoice Plus covers only. 12-month waiting period applies. A benefit of 70 percent of the cost of a screening mammogram up to a maximum of $100 is payable once every two years, where no Medicare rebate is payable.

Reference: 1 Australian Government Department of Health and Ageing, ‘BreastScreen Australia Program’, cancerscreening.gov.au/ internet/screening/publishing.nsf/Content/breastscreen-about

Get checked and get involved Pink Ribbon Day: October 22, 2012. To get involved, visit pinkribbonday.com.au.

To make an appointment for a screening mammogram, call BreastScreen on 13 20 50.

To find out more about Australian Unity’s mammograms screening program, call 13 29 39 or go to australianunity.com.au/mammograms

Caroline Murodono Caroline Murodono balances her career at Australian Unity in Melbourne with a varied selection of hobbies… right now, that includes a passion for electric tools!

What’s your idea of relaxation?

If I’m stressed, I play the piano to balance my state of mind. You can’t take your anger out on an expensive instrument for too long, so it’s pretty effective.

Where do you work and what do you do?

I work as a Senior Data Analyst, part of the BI (Business Intelligence) team within Business Technology. We work closely with the health-marketing department to provide data for campaigns and reports.

Where and when are you happiest?

My most recent ‘happiest’ moment was when I was given a circular saw and workbench for my birthday from my friends/colleagues! My future birthdays will suffer as a result.

Reveal a secret talent that you have.

I don’t know if it’s a talent but I’ve made a few cabinets. It came out of necessity as I have some voids in the house with strange measurements.

What do you love about living in Melbourne?

What’s not to love? We have a very green city with four seasons, awesome coffee and wicked food never too far from anywhere.

Which of your furniture creations are you most proud of and why?

All of them are precious but, if I had to pick one, it would be the day bed by the window (don’t tell the other cabinets!). I recycled timber from an old couch and that was the very first piece I completed. The best part is that it’s mostly concealed under a seat cover.

What is the best piece of advice anyone has given you?

Don’t listen to other people’s advice. Just kidding. I do go by the motto ‘do unto others as you would have them do unto you’ – though I had to Google that to get the exact words right! wellplan > 5

know your cover

Starting

afresh

Bad habits, such as smoking, can be hard to break – that’s why Australian Unity is here to help.

Words Kate Cross, HealthLogix

Smoking, overeating, skipping breakfast, neglecting exercise – we all know these are bad habits, but why are they so hard to break and, more importantly, how do we break them?

For psychologist and author Dr Elizabeth Celi, when it comes to breaking habits, there is no specific timeline; it can take days, weeks or even months. “How emotionally attached you are to the habit is a function of how long it takes to break,” says Dr Celi.

It also depends on how fed up you are with the habit: the more discontented, the greater the momentum to change – as long as the outcome or the reward has more meaning than the old habit.

It may take several attempts before the old habit dissolves and the new habit

Member benefit

Reward your efforts

In recognition of the many hurdles that smokers face, Australian Unity encourages members to take advantage of benefits towards a quit smoking program. Those looking to make a fresh start will receive up to $120 on completion of an approved quit smoking course, depending on your level of cover, which are run by

is entrenched, says Dr Celi. “Expect this and be kind to yourself in the process!”

Emotional ties It’s not just the habit itself that is involved in the discarding process; it also involves letting go of the comfort and security that surround the habit.

“There’s a lot of emotional baggage that goes with a habit,” explains Dr Celi, pointing to smoking as an example. “What is a smoker’s attachment to smoking?” she asks. “Is it a social lubricant? Does it keep [the smoker] occupied because they’re socially nervous?”

Ultimately, it’s this emotional or psychological attachment that can make habits hard to break.

Smokenders, Allen Carr’s Easyway and the QUIT Foundation*.

To claim your benefit, simply send the receipt from your approved quit smoking provider, along with a completed claim form, to Australian Unity. It’s that easy.

So, if you’re ready to tackle your habit, remember that the rewards are there for the taking – both for your health and hip pocket. *Available with all Hospital, Combination and Extras covers, except Care ’n Repair, Budget Hospital, Budget Extras and Overseas Visitors Cover. Where a member has both Hospital and Extras cover, benefits may only be claimed under the Hospital cover.

For more information, call 13 29 39.

Six good reasons to

quit smoking 1 Within a day, almost all of the nicotine will be out of your bloodstream.

2 Within two months, your immune system will have begun to recover and your lungs will no longer be producing extra phlegm caused by smoking.

3 After one year, your blood pressure will return to normal.

4 Within two to five years, there will be a large drop in your risk of heart attack and stroke.

5 After 10 years, your risk of lung cancer will be markedly lower than that of a smoker and will continue to decline (provided the disease is not already present).

6 After 15 years, your risk of heart attack and stroke will be almost the same as that of a person who has never smoked.

Source: quit.org.au

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know your cover

Wellness for Everyone

The answers to all your health and lifestyle questions are now just a click away, thanks to Australian Unity’s Wellness for Everyone online support program.

It’s perfectly normal – and even wise – to be curious when it comes to matters concerning your wellbeing. Whether you’re experiencing something for the first time or are just unsure about a particular aspect of your health, it’s natural to ask questions.

In times past, that meant seeking advice and talking to people, either in a professional or personal capacity. But in today’s busy, technology-driven world, the internet has become an increasingly important source of information and an extremely beneficial tool when it comes to preliminary investigations.

Accessible advice Australian Unity provides members with a range of support services to help improve wellbeing. Wellness for Everyone is a practical tool designed to address matters that

concern everyone. Its useful articles provide insight into issues that affect women, men and children at all stages of life.

With this bounty of knowledge at your fingertips, you’ll not only save valuable research time but, from the privacy of your own computer, will be able to explore sensitive subjects that you might otherwise have felt too embarrassed to address.

Stay informed Wellness for Everyone brings together a collection of helpful information, categorised according to your particular area of interest.

Women, for example, may wish to read the latest news about contraception or infertility; men may be more interested in subjects such

as snoring and sleep apnoea. And parents will have access to a wealth of advice relating to the different developmental stages of their children, from vaccination guidelines to healthy school lunch ideas. Plus, there’s an entire section dedicated to pregnancyrelated issues, from morning sickness to breastfeeding, designed for parents and parents-to-be.

Wellness for Everyone contains straightforward and up-to-date information to help you explore the health issues that are most important to you. Whether you’re looking for information relevant to yourself, your partner or your child, there’s always something new to discover within the world of health and wellbeing.

To find out more, visit australianunity.com.au/wellnessforeveryone wellplan > 7

SPOTLIGHT ON

Brain reaction Strokes can strike anyone. According to a 2010 report from the Australian Bureau of Statistics, stroke is the second most common cause of death in Australia. The National Stroke Foundation reports that one in six Australians will have a stroke in their lifetime and that someone has a stroke every 10 minutes1.

Thankfully, these alarming figures do not have to include you. Not only can you take measures to prevent stroke, but, by understanding its symptoms and signs, you can also help others increase their chances of survival.

There are two main forms of stroke.

Ischaemic stroke occurs when an artery becomes blocked and areas of the brain are subsequently starved of oxygen.

Haemorrhagic stroke, on the other hand, is caused by blood vessels in the brain rupturing as a result of factors such as head trauma or high blood pressure.

Both types of stroke set off a chain reaction of cell death in surrounding tissue, which leads to the loss of irreplaceable brain cells and, in turn, permanent damage.

The causes of ischaemic and haemorrhagic stroke are complex, triggered by anything from heart attacks to blood clots in major arteries and complications with high blood pressure. And it’s not just older people who are affected: children and young adults are also susceptible.

National Stroke Foundation CEO Dr Erin Lalor advises that an ambulance should be called immediately if stroke is suspected. “Prompt treatment can save a life or reduce the degree of disability the person may suffer,” says Dr Lalor. “In some types of stroke, some people may be able to receive a clot-busting treatment that can reverse the effects of the stroke. But this treatment can

8 > wellplan

Stroke is one of the leading causes of death in Australia. Fortunately, there are measures you can take to beat the statistics.

WORDS James Baldwin

only be given within 4.5 hours of the onset of symptoms.”

The National Stroke Foundation has answered this need for rapid response by developing FAST, a system to help identify the symptoms of stroke: Check their FACE. Has their mouth drooped?

Can they lift both ARMS? Is their SPEECH slurred? Do they understand you?

TIME is critical. If you see any of these signs, call 000 straight away.

According to Dr Lalor, the single biggest modifiable risk factor for stroke is high blood pressure. “Everyone should know their blood pressure and if it is high, take steps to reduce it,” she says. “This can be done on advice from your doctor, who may recommend more exercise, giving up smoking if you

smoke and eating less salt and fatty foods and more fresh fruit, vegetables and lean meat.”

Taking such simple measures will not only drastically reduce your risk of suffering from stroke but could also save your life.

Reference: 1 National Stroke Foundation, strokefoundation.com.au

National Stroke Week National Stroke Week 2012 will be held from Monday 10 to Sunday 16 September. To get your free Stroke Week pack, to learn more about National Stroke Week or for any other related information, email strokeweek@strokefoundation.com.au or contact 1800 STROKE (1800 787 653).

UNDERSTANDING YOUR COVER

“People enjoy the course,” says Chu. “They find that our training is very practical, because we use a lot of scenarios and it’s easy to follow.

And they feel confident in applying it.”

Taking action If you encounter a medical emergency and you have been trained in CPR, your approach should always be the same: follow the easyto-remember DRSABCD action plan.

Saving

lives

Danger Ensure the area is safe

Response Check for response – ask name, squeeze shoulders

Airway Open mouth – clear any foreign material present

Breathing If not breathing normally, start CPR

CPR Give 30 chest compressions, followed by two breaths at the rate of five cycles in two minutes. Continue until help arrives or patient recovers

First aid skills are easy to learn and can make a vital difference in life-threatening situations.

At Australian Unity, we believe it’s important for our members to know what to do in a medical emergency. When confronted with an ill family member, friend, work colleague or stranger, your response to different scenarios – such as sudden cardiac arrest (SCA), a leading cause of fatality in Australia1 – could be the difference between life and death.

While the precise number of people who die from SCA in Australia is not known, the nearest estimates range from 23,000 to 33,000 per year1. Cardiopulmonary resuscitation (CPR) offers a potentially life-saving treatment, increasing a victim’s chance of survival if started soon after the heart has stopped beating2. If no CPR is performed, it only takes three to four minutes for the person to become brain dead, due to lack of oxygen2.

“Currently, fewer than half the cardiac arrest victims get resuscitation from bystanders,” says Professor Ian Jacobs, National Chair of the Australian Resuscitation Council. “If we can increase the number of people who are prepared to give resuscitation, we will save lives3.”

For every minute that CPR is not done following an incident of SCA, a person’s chance of survival decreases by 10 percent4.

By performing CPR correctly, you can keep

blood and oxygen flowing, so that the brain and other organs stay alive while you wait for an ambulance to arrive.

Send for help If no response, call 000

Defibrillator Apply defibrillator (if available and you are trained in using one) and follow voice prompts

Source: stjohn.org.au

Life lessons Any CPR is better than none, and having a basic understanding of what to do can help save a life. Completing a first aid course will empower you with the skills and knowledge to provide the appropriate response, life support or casualty management until further medical assistance is available. That’s why Australian Unity encourages members to undertake first aid training, offering special benefits in conjunction with St John Ambulance Australia.

According to Ruby Chu, Training Development Manager at St John Ambulance Victoria, the obvious benefit of a first aid course is that you could one day put your skills into practice and save somebody’s life.

“One of my greatest job satisfactions is seeing a bystander perform CPR,” she says.

Anyone lacking confidence in their first aid abilities should set their fears aside.

Sign up and save

Member benefit

Receive $75 per membership on completion of a St John Ambulance one-day Provide Basic Life Support course OR $60 per membership on completion of a St John Ambulance Apply First Aid course*.

To claim your benefit, simply login or register for Online Member Services at australianunity.com.au/memberservices or call Teleclaims on 1800 807 114. *Available on all Combination covers except Smart Start and Care ’n Repair. Benefit payable once every three years.

Reference: 1 Cardiac Arrest Survival Foundation, cardiacarrest.org.au/sudden_cardiac_arrest 2 Better Health Channel, Fact Sheet – Cardiopulmonary resuscitation (CPR) (2011), betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Cardiopulmonary_resuscitation_(CPR) 3 Australian Resuscitation Council (2006), ‘Saving lives with CPR has never been easier’, resus.org.au/guideline_press_release_2006.pdf 4 Learn CPR The Key to Survival (2011), ambulance.vic.gov.au/Media/docs/4SFL%20Group%20Kit%20DL%20Brochure%20-%20Jul%20 2011-67ac23e7-9b33-41db-bf56-5a4ceae3e741-0.pdf

wellplan > 9

Think

before you

drink

expert opinion

New research reveals the impact that alcohol can have on the adolescent brain.

WORDS Kimberly Gillan

You booze, you lose Here’s how alcohol consumption can affect adolescent brains.

Short term

Up until recently, scientists believed that most human brain development occurred before birth and in early childhood1.

But new studies have found our brains actually keep developing until we’re in our early 20s and that drinking alcohol during that period can be damaging1.

“It was assumed in the past that once you were past puberty and into your adolescence, you were more or less dealing with an adult brain – that’s not true,” says Professor Ian Hickie, Executive Director of the Brain & Mind Research Institute at the University of Sydney.

“What’s very clear from modern brain imaging and psychological studies is the extent to which binge drinking, which is common in young people, actually causes damage to developing areas of the brain.”

With the average Australian teenager consuming alcohol from the age of 15½1, Professor Hickie says we need to educate teens about the impact that drinking can have on brain development.

“We’ve seen a shift to spirits and wine drinking compared to beer drinking … [which leads] to very high blood-alcohol levels, and that is what potentially does great damage to your brain, as it does to your liver and other organs,” he says.

Risky business The biggest danger for adolescents drinking alcohol is damaging the frontal lobes of the brain – the section responsible for judgement, complex decision-making, planning for the future and parts of our memory, which continues developing into our early 20s.

“Drinking alcohol causes damage to some of the memory centres and the connections between the frontal lobes and other parts of the brain that are essential to development from being a child to being an adult,” explains Professor Hickie.

This part of the brain helps us learn from our mistakes and predict what might happen

if we do something stupid. “You turn smart decision-making processes off when you are intoxicated,” says Professor Hickie.

Not only are teenagers who drink risking damage to their brains, but they’re also more likely to engage in dangerous behaviour while they’re drunk, such as drink driving, violence and unwanted sex. In fact, it’s estimated that one teenager dies and 60 are hospitalised every week in Australia from alcohol-related causes2.

The mental fallout The correlation between teenage drinking and the onset of mental health issues is also alarming.

“Mental health problems are made worse by alcohol use,” says Professor Hickie. “From a mental health perspective, this [adolescent] period is terribly important for sorting out other problems and not complicating them through excessive alcohol use.”

Younger drinkers are also more at risk of becoming alcoholics. US studies show that people who begin drinking when they are 15 are four times more likely to become an alcoholic than people who start drinking after the age of 213.

“Alcohol patterns of misuse start young and become severe when you are young,” explains Professor Hickie. “And it may well be through the adverse effects on brain development that you become stuck in those patterns of drinking.”

Spreading the message The evidence is clear that the longer teenagers can delay drinking, the better their chances of healthy brain development.

But convincing teenagers to steer clear of alcohol until they’re at least 18 can be difficult for parents.

While some people believe introducing alcohol to adolescents at home deters them from binging with friends, Professor Hickie believes this is not a good idea.

“It’s highly contestable that somehow

Damage the memory centres Impair decision-making ability Increase the chance of risk-taking Poorer concentration Exacerbated mood problems

Long term Increase the chance of mental health problems More likely to develop alcohol-related problems Possible impact on long-term memory and learning4

socialising them at home will have any effect over their drinking behaviour outside of home,” he says.

Instead, Sydney psychologist Melissa Podmore suggests that parents start educating their children from the age of 12 about the dangers of drinking. “It needs to be something we are repeatedly discussing with kids, just like we would have done with stranger danger when they were four,” says Podmore. “It’s important to show how they can say no to pressure [to drink].”

Parents also need to lead by example.

“Whatever kids see, regardless of what you say, is what they are going to learn,” Podmore points out. “Don’t drink all the time to manage stress – let your child see you do other proactive things to help with stress.

And don’t drink every time you socialise, so they can see there are times that it’s not just part of adult fun.”

References: 1 Drinkwise, drinkwise.org.au/parents/parents-of-15-17/ kids-and-alcohol-don’t-mix 2 Australian Government National Health and Medical Research Council, nhmrc.gov.au/your-health/ alcohol-guidelines/alcohol-and-health-australia 3 The Salvation Army, ‘The facts: binge drinking and alcohol abuse’, salvos.org.au/ need-help/the-facts/documents/Bingedrinking.pdf 4 Hiller-Sturmhöfel, S., Swartzwelder, H. Scott, ‘Alcohol’s effects on the adolescent brain – what can be learned from animal models’, pubs.niaaa.nih.gov/ publications/arh284/213-221.htm

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Seeking

support The Cancer Council is on hand to provide support to those with skin cancer.

To talk to one of their experienced and caring nurses, contact the Cancer Council Helpline on 13 11 20.

Over the

sun

Outdoors enthusiast Steve Badger is speaking from experience when he says that enjoying Australia’s sunshine requires a cautionary approach.

WORDS ANDREW TURNER PHOTOGRAPHY JARROD BARNES

member in focus

“I think the sooner you get things checked out, the less impact it has long term.”

Growing up in sub-tropical Brisbane in the 1970s and ’80s, a freckled and fair-skinned Steve Badger enjoyed an idyllic childhood.

His days were whiled away playing backyard cricket in his swimming trunks beneath the blazing summer sun, sloshing around on slippery slides or splashing about in the waves along Queensland’s stunning coastline.

Outdoor sport was a staple – Steve played club and representative cricket from an early age – and the combination of regular training and weekend matches meant exposure to the relentless summer sun seven days a week.

He and his teammates wore the traditional, small-peak caps that provided little coverage or protection, and the school playground was no better, with today’s ‘no hat, no outside play’ rule still a long way off.

In a time when sun-awareness campaigns hadn’t yet been seared into public consciousness, Steve recalls that while he was aware of the dangers of the sun during his childhood years, he had no inkling that those hedonistic days would later wreak such havoc on his pale skin.

“We were aware of the sun’s dangers, but it wasn’t pushed upon us as it is now,” he remembers. “Our neighbour was a sales representative for Parke-Davis [Pharmaceuticals] and I remember using that anti-burning cream a few times to calm down the odd sunburn that you’d get.”

As a young teenager, Steve and his family relocated to Melbourne, where the budding all-rounder continued to play junior cricket and later on grade cricket as an adult, further exposing his hands and face to the fierce sun’s rays as he stood in the field for hours on end.

Acutely aware that his Scottish background and the light complexion that went with it made for “a typical profile that you don’t want to mix with the sun”, from his early 20s he began having annual skin check-ups and from time to time would require treatment involving dry ice or nitrogen to burn sunspots off his face and the back of his hands.

Then, aged in his late 30s, Steve developed what he thought was “a little scratch or pimple” that wouldn’t heal. Although he’d identified the persistent scab in his ear, he didn’t show it to his doctor in his annual skin check-up, meaning it was another 12 months before he returned and raised the potential problem spot.

“I knew something was up because with typical cleaning with a cotton bud around the ear canal, I noticed what felt like a scab or something at the base,” he explains. “I’d scratch it and it would come back; it just didn’t heal.

Eventually, I went and saw a doctor and tried some creams and ointments but it didn’t clear up after about three or four attempts.”

The “little scratch or pimple” was diagnosed over a year later as a basal cell carcinoma (BCC), a common type of skin cancer, which resulted in four operations over a 12-month period during 2011.

For the first operation, his doctor removed the BCC and created a graft – essentially plugging the hole with skin taken from behind his ear – while Steve was under general anaesthetic. When he returned for a check-up, his doctor informed him there was still some cancer on the margins. Six months after the first operation, Steve went under the knife again, only to be told that, yet again, the BCC hadn’t been completely removed.

At his doctor’s recommendation, Steve consulted a plastic surgeon – this time to discuss plans for what would be his third operation. This would involve a skin-flap procedure, where the surgeon would cut a hole through the base of Steve’s ear and “pull the skin through so it was still alive”, then stitch that skin over the affected area.

The following day, Steve was informed there was still some cancer present so, a couple of days after his third operation, he went in for his fourth. “He had to take quite a bit more of the base of my ear, the gristly bit around the bottom,” says Steve.

After four operations, Steve finally received the good news he had expected

to hear months earlier: the BCC was fully removed. Fortunately, his ear is still fully intact, albeit it’s “pinned back to the head a little bit”.

“I’m lucky that it wasn’t higher up on the ear because I probably would have lost the top of my ear,” Steve, now aged 42, explains.

Despite the ordeal, he insists he kept calm and optimistic throughout but remembers feeling a little uneasy after each operation as to how he would look.

“When they’d take the bandages off, it looked quite ugly,” recalls Steve. “There was skin and gristle and blood and I’d think, ‘how am I going to go out in public?’ But I suppose I don’t notice it anymore, so in that way it’s a bit of a change and a sense of achievement in getting rid of it, finally, after four goes.”

Involved in the display graphics and printing industry since entering the workforce, Steve’s career has taken him back to Brisbane to live and to Delhi, India, where he met and married his wife.

The couple have two children and, while Steve says they’re lucky their “skin is a little better than mine”, he and his wife stress the importance of being diligent with sunscreen and spreading it on all areas of skin exposed to the sun – including the inside of the ears – as well as the need to cover up with broad-brimmed hats and long-sleeved shirts.

Asked what he’d do differently if he were faced with the same scenario again, Steve says, without hesitation, that he’d consult his doctor and have anything that caused concern looked at immediately.

“I think the sooner you get things checked out, the less impact it has long term.”

What’s your story?

To tell us your story and have your chance to be on the front cover of wellplan, write to us by 19 October 2012, at wellplan@australianunity.com.au or wellplan, Front Cover Story, Reply Paid 64466, South Melbourne, VIC 3205 (no stamp required).

wellplan > 13

The

mouth-body connection Oral health can offer clues about a person’s general wellbeing, so don’t underestimate the importance of regular dental check-ups and caring for your teeth.

WORDS Jessica Gadd

While we all know it’s important to look after our teeth in order to avoid cavities and other dental problems, it’s less well known that good oral health is linked to good overall health and vice versa.

Dr Donald Chin, a dentist at Australian Unity’s Melbourne and Box Hill dental clinics, says there are two ways the mouth and other parts of the body are connected.

Firstly, symptoms present in the mouth may show that there are already other more serious conditions elsewhere in the body and, secondly, that poor oral hygiene can lead to poor health or serious conditions developing somewhere else in the body.

“If you look at the variety of tissues in and around the mouth – mucous membranes, teeth, muscles, lymph glands and joints of the jaw – it’s not surprising that you might find signs of systemic disease presenting in the mouth,” says Dr Chin. “So, when we do a check-up for a patient, we’re not just looking at gums and teeth but checking the whole mouth, too.”

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Warning signals Health professionals believe the mouth can serve as a mirror to the body and that oral health is integral to general health1. Dr Chin says a dental examination can reveal the early stages of many medical conditions, including thyroid problems, high blood pressure, asthma, sleep and breathing disorders, eating disorders and auto-immune disorders such as lupus and HIV2.

Many systemic diseases (diseases involving many organs or the whole body, such as some cancers, diabetes, cardiovascular disease,

Crohn’s disease and rheumatoid arthritis) have oral manifestations like inflamed or swollen gums and mouth ulcers2.

“One of my colleagues checked a white lesion for one of the dental nurses, which turned out to be cancer,” says Dr Chin. “She was lucky to have it identified early enough to be successfully treated, and as a result, she only lost a small part of her tongue. If it had advanced further, she may have been looking at a much worse outcome, so the message is clear – visit your dentist regularly.”

facts on

Brushing up Effects of poor oral hygiene Left untreated, the symptoms of poor oral hygiene can lead to respiratory infections like pneumonia and chronic obstructive pulmonary disease3.

Periodontal, or gum, disease is an inflammation of the gums that also results from poor oral hygiene. It is chiefly known for its role in leading to the loss of teeth, but it is also a bacterial infection that can enter the bloodstream and play a part in other health complications throughout the body. For example, many studies have identified links with cardiovascular disease3, with researchers finding that people with gum disease are almost twice as likely to suffer from coronary artery disease as those without gum disease4.

Additionally, studies have found that pregnant women with gum disease may be more likely to have a baby born pre-term or with a low birth weight1. One of these studies concluded that women with a periodontal disease had a 4.28-times greater risk of a pre-term baby than women with good gum health5.

“These studies only identify an association between the two and conclude that more research is needed to establish a definite causal link,” adds Dr Chin.

“However, until there’s evidence to the contrary, we should treat any gum disease present, as the condition is very treatable and if managed appropriately, will improve a patient’s overall health.”

Who is more at risk?

Women are more susceptible to gum disease during pregnancy and menopause because changes to hormone levels exaggerate the way the gum reacts to the

presence of dental plaque. Dr Chin suggests women at these stages of life consult a dentist if they experience bleeding of the gums (a sign of pregnancy gingivitis) or a dry mouth (a common symptom experienced during menopause as a result of less saliva being produced, which can lead to tooth decay). Diabetics, too, are more susceptible to gum disease1,3.

“Diabetes can go both ways,” says Dr Chin. “It seems that diabetics are predisposed to gum disease, and if periodontal disease is present in a diabetic, it can contribute to diabetic complications.

For example, one study shows that type 2 diabetics with severe periodontitis – an inflammation and infection of the ligaments and bones that support the teeth – have three times the risk of death from heart disease and diabetic nephropathy [kidney disease] than those with no, mild or moderate periodontitis.”

Dr Chin says he offers to put patients with diabetes in touch with the Australian Unity Diabetes Program, which is run by Accredited Practising Dietitians and offers telephonebased support and coaching to help members with type 2 diabetes live well and reduce the risk of long-term complications.

Preventing dental disease It’s now widely recognised that the dental profession has an important role to play in the detection, early recognition and management of a wide range of oral and general diseases and conditions1,3.

Dr Chin says regular use of your toothbrush and dental check-ups could turn out to be your best weapons against dental disease, as well as playing a significant part in maintaining your overall health.

Celebrate World Oral Health Day on 12 September 2012 by ensuring you’re following these five simple steps:

Eat well – enjoy a wide variety of nutritious foods and healthy snacks, while limiting your intake of sweet foods (especially between meals).

Drink well – drink plenty of tap water and avoid sweet or fizzy drinks.

Stay well – don’t wait for a problem; have regular oral health check-ups. If you smoke, quit for good.

Play well – wear a professionally fitted mouthguard when training and playing contact sports.

Clean well – brush your teeth with fluoride toothpaste and a soft toothbrush at least twice a day and floss at least once a day.

For more information, visit dhsv.org.au

References: 1 ‘Oral health in America: a report of the Surgeon General – executive summary’, Rockville, MD. US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000. 2 ‘Oral manifestations of systemic disease’, Chi AC., Neville BW., Krayer JW., Gonsalves WC. American Family Physician, December 1, 2010. 3 ‘Periodontal disease and systemic health: current status’, Cullinan MP., Ford PJ., Seymour GJ. Australian Dental Journal, issue 54, 2009. 4 American Academy of Periodontology: perio.org/consumer/mbc.heart.htm 5 ‘Periodontal diseases and the risk of pre-term birth and low birth weight: a meta-analysis’, Khader, Dr Yousef S and Ta’ani, Quteish, Journal of Periodontology, February 2005, Volume 76, No. 2: p161-165.

Something to smile about Under Australian Unity’s No Gap Dental Service, members with dental cover are offered preventive dental services at no out-of-pocket cost*, including examinations, scale and clean, X-rays, topical fluoride treatment and custom-made mouthguards for protecting your teeth during contact sports. These preventive services are available

exclusively from No Gap Dental Service providers, chosen by Australian Unity for their ability to provide quality care and their use of leading-edge technology.

Full details can be found at australianunity.com.au/nogapdental or by calling 13 29 39. * Subject to yearly limits

wellplan > 15

Cover up The approaching summer heralds outdoor fun and relaxation… but it’s also the season to be skin savvy.

WORDS Andrew Turner

focus on

Taking action When it comes to skin cancer, our sunburnt country – along with neighbouring New Zealand – is the undisputed world champion. It’s hardly a tag to be proud of, but the fact is that we live in a sun-drenched region with high levels of solar ultraviolet radiation, and that can prove a dangerous combination.

Figures provided by Cancer Council Australia reveal two out of three Australians will be diagnosed with skin cancer by the time they’re 70, and, according to Australian Bureau of Statistics 2010 figures, a staggering 1,850 Australians die of skin cancer annually.

Confirming our unenviable reputation, a 2010 report by the Australian Institute of Health and Welfare reveals Australians are 13 times more likely to develop skin cancer than the global average. As summer approaches, these disproportionately high figures should be at the forefront of all Australians’ minds, says Terry Slevin, Chair of Cancer Council Australia’s Skin Cancer Committee and Director of Education and Research at Cancer Council WA. “As we go into the Australian summer, it’s important to understand that skin cancer prevention is a priority, whether you’re in Hobart or in Darwin,” says Slevin.

DECENT EXPOSURE Adequately protecting the skin and eyes, both of which are vulnerable to the damaging effects of the sun’s UV rays, relies on a variety of factors, according to Slevin. “The thing that is most important is avoiding the sun around the middle of the day when the UV index is at its highest,” he says.

While some exposure to the sun is necessary to maintain an adequate intake of Vitamin D, which is essential for keeping bones and muscles in good health, Slevin says that aside from those who are immobile or infirm and people who cover their skin from head to toe for cultural or other reasons, few Australians

Member benefit

suffer from Vitamin D deficiency. Attaining adequate levels of Vitamin D, he insists, requires only minimal sun exposure and shouldn’t be a concern for the average Australian.

fighting the elements Apart from staying out of the sun during the middle of the day, Cancer Council Australia recommends wearing UV-protective clothing, broad-brimmed hats and sunglasses, as well as making use of sun shelters and frequently applying SPF30+ sunscreen.

In regard to sunscreen, Slevin adds some advice. “Some people use too little to achieve necessary sun protection, and some people don’t put it on early enough – they wait until they get to the beach before applying it.

“Another [problem] is applying sunscreen just before jumping into the water and therefore the sunscreen doesn’t have enough time to bind to the skin’s surface.”

Cancer Council Australia says those who don’t heed the warnings about excessive sun exposure leave themselves susceptible to dehydration resulting from the heat, sunburn and sunstroke, and more long-term effects like skin cancer and melanoma. Monitoring these adverse effects, says Slevin, is crucial. “Obviously, early detection is important,” he asserts.

Because there are so many variables influencing the risk, including skin type, age and history of time spent in the sun, Slevin believes an initial assessment is best undertaken by a GP. “Some people suggest this is done annually, some suggest that’s too often, and for people with a history of skin cancer, that may not be often enough. So, it’s horses for courses and that’s why people should consult their GP,” he says.

THE EYES HAVE IT Skin aside, the other part of our anatomy that the sun can treat harshly is our eyes.

National Skin Cancer Action Week is held just before the start of every Australian summer. The aim of the campaign is to raise awareness of skin cancer and promote healthy habits when it comes to sun protection.

Be sure to look out for National Skin Cancer Action Week from 18 to 24 November 2012.

To find out more, visit cancer.org.au

Prolonged UV exposure contributes to a condition called pterygium, which is a growth over the eyeballs that can affect people’s sight.

In rare cases, melanoma of the eye can also occur. With water and sand at the beach particularly proficient at reflecting UV radiation, sunglasses are an obvious solution, particularly those with an effective UV rating. “Sunglasses should meet the Australian mandatory standard [AS/NZS 1067],” advises Slevin, “and people need to be very careful of cheap imported sunglasses because they may not have had the Australian safety standards applied to them.”

Location also plays a major role in sun protection management, according to Slevin, and this is where local information is imperative. Cancer Council Australia recommends checking the UV index, which can be found on its website and in most daily newspapers, before stepping outdoors.

“We generally recommend protecting yourself from the sun when the UV index exceeds the level of three,” says Slevin. “It will struggle to exceed the level of three during the winter in Hobart, but it’s always going to exceed the level of three throughout the year in Darwin. So, that geographical difference is very important in Australia.”

Australian Unity exclusive offer

Eyecare Advantage understands that our eyes are vulnerable under the powerful Australian sun and therefore offers Australian Unity members with optical cover a free pair of prescription sunglasses with every purchase of complete spectacles.

To read more about this and other special offers from Eyecare Advantage, turn to our ‘Australian Unity & You’ feature on page 4.

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eat well

Sweet talk

While consuming excessive quantities of sugar can cause health problems, is it wise to remove it from your diet altogether?

WORDS Julie Martin

In today’s diet-obsessed society, there are many differing opinions on the role of sugar in our lives. Some nutritional experts suggest avoiding it at all costs; others take the line that it’s okay – and even necessary – when consumed in moderation. Either way, there is one point that all parties tend to agree on: excessive consumption of the sweet stuff is not a good thing.

What is sugar?

Sugars are carbohydrates that generate energy in our diet. The body breaks down carbohydrates into sugar (glucose) that can be readily used for energy.

There are many different types of sugars in foods. Sugars occur naturally, such as in fruit and dairy products, and are also added to a wide variety of foods – often to make them more palatable, as in breakfast cereals. Sugar comes in many different forms, including white, raw or brown sugar, honey and corn syrup. All sugars are, generally, equal in their energy content and have 16kJ (kilojoules) per gram.

How much added sugar is acceptable?

A moderate amount of sugar can be included in a healthy, balanced diet, with ‘moderate’ defined as 10 percent of your total energy intake per day1. One teaspoon of sugar added to porridge is quite acceptable, owing to the high nutritional value of this breakfast cereal, whereas soft drink usually contains high levels of sugar but has no other nutritional benefits. A regular 600ml bottle of soft drink contains at least 12 to 15 teaspoons of sugar, and consuming such beverages will lead you to greatly exceed your recommended energy allowance from sugar, which may result in weight gain1.

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eat well

Is sugar addictive?

In research studies, rodents have shown addictive behaviour to sugar; however, there are no human studies that support the hypothesis that it may be physically addictive or that addiction to sugar plays a role in eating disorders2.

Sugar and our health There has been much debate about the link between high sugar intake and being overweight or obese. A recent Australian study analysing the trends in obesity and sugar consumption over the past 30 years found that, even though the prevalence of obesity has increased threefold since 1980, our per capita consumption of sugar has decreased by 23 percent3. This suggests that we need to consider our total energy intake and the nutritional quality of our overall diet in order to maintain a healthy weight in the long term, rather than focus on single nutrients alone3.

Will reducing sugar intake help you lose weight?

While sugar does contribute to the energy density (number of kilojoules) of foods and drinks, it contains fewer kilojoules than fat. However, it is easy to overindulge in foods and drinks with a high sugar content because of the low satiety of these foods1.

Therefore, swapping soft drinks for water – or even diet drinks – and cutting out other foods that contain sugar will help you reduce your total kilojoule intake. This, in turn, will lead to longer-term weight loss4.

Removing natural sugars from your diet, thus eliminating nutrient-rich fruits and milk, is not a sensible solution. Sugar, as a nutrient class, does not contribute any more to obesity than an excess of fat or other carbohydrates4 and is therefore not something to fear. So, enjoy the sweeter things in life but, as with any other indulgence, do so in moderation.

References: 1 Better Health Channel, Fact Sheet – Sugar (2011): betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Sugar 2 Benton, D., (2010): ‘The plausibility of sugar addiction and its role in obesity and eating disorders’. Clinical Nutrition, p288–303. 3 Barclay, A., Brand-Miller, J. (2011): ‘The Australian paradox: a substantial decline in sugars intake over the same timeframe that overweight and obesity have increased’. Nutrients (3), p497–504. 4 The Conversation (2012): ‘Monday’s medical myth: sugar is to blame for our obesity epidemic’.

Retrieved from theconversation.edu.au/mondays-medical-myth-sugaris-to-blame-for-our-obesity-epidemic-6078 v

Bran muffins Makes 12 180g (1 cup) pitted dates, chopped Zest of 1 orange 65ml orange juice 95g (½ cup) soft brown sugar 125ml (½ cup) light-flavoured oil, such as sunflower 125g (½ cup) yoghurt 2 eggs, lightly beaten 150g (2 cups) unprocessed bran 120g (¾ cup) plain flour 2 teaspoons baking powder 1 teaspoon ground cinnamon

1. Preheat the oven to 180°C and line a 12-hole muffin tin with paper cases.

2. Put the dates and 185ml (¾ cup) boiling water in a bowl and leave to soak for a few minutes.

3. Meanwhile, put the orange zest and juice, sugar, oil, yoghurt, eggs, bran, flour, baking powder and cinnamon in another bowl. Add the dates and their soaking water and mix together well.

4. Spoon into the muffin cases and bake for 25–30 minutes or until a skewer comes out clean when poked into the middle.

Cool on a wire rack.

Recipes and images from Bill’s Basics cookbook, by Bill Granger, published by HarperCollins, $49.99rrp.

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eat well

Noodle salad with prawns, cashews and mint Serves 4–6 2 tablespoons caster sugar 2 tablespoons rice vinegar 1 large carrot, peeled and cut into thin batons 200g rice vermicelli noodles 1 teaspoon light-flavoured oil, such as sunflower Sea salt 24 large cooked prawns, peeled, deveined and halved lengthways 1 Lebanese cucumber, cut into chunks Large handful mint leaves 50g ( cup) cashew nuts, lightly toasted and chopped Lime wedges, to serve

Chicken satay Serves 4 Marinade 1 lemongrass stalk, crushed with the back of a knife and roughly chopped 3 garlic cloves, roughly chopped 3cm piece fresh ginger, peeled and roughly chopped 1 tablespoon sugar 1 teaspoon sea salt 1 teaspoon turmeric 50g ( cup) dry-roasted peanuts 4 skinless chicken thighs, halved lengthways Satay sauce 250ml (1 cup) coconut cream 1 tablespoon red curry paste 100g ( cup) coarsely ground dry-roasted peanuts 1 tablespoon soft brown sugar 2 tablespoons soy sauce 1 tablespoon lime juice To serve Fresh pineapple, cut into chunks Red onion, cut into chunks Cucumber, cut into chunks

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1. Whiz the lemongrass, garlic, ginger, sugar, salt, turmeric, peanuts and 125ml (½ cup) water in a blender or food processor until smooth. Transfer to a large bowl, add the chicken and toss well to coat. Cover and leave to marinate in a cool place for at least 1 hour.

2. If you’re using skewers, preheat the grill to high (if you’re using wooden skewers, soak in water beforehand to prevent scorching). Thread the chicken onto 8 skewers and grill for 5–8 minutes on each side. If you’re not using skewers, barbecue or pan-fry the chicken in a non-stick frying pan over medium to high heat for 5–8 minutes on each side.

3. To make the satay sauce, heat half the coconut cream in a saucepan over medium heat until just simmering. Stir in the curry paste until smooth and fragrant.

Add the peanuts, sugar, soy sauce, lime juice and the rest of the coconut cream and stir for 5 minutes until thickened.

4. Serve with satay sauce and chunks of pineapple, onion and cucumber.

Chilli dressing 1 red chilli, deseeded and roughly chopped 1 green chilli, deseeded and roughly chopped 2 garlic cloves, roughly chopped 2 tablespoons soft brown sugar 3 tablespoons fish sauce 3 tablespoons lime juice 2 red Asian shallots, roughly chopped 1 tomato, roughly chopped

1. Mix together the caster sugar and vinegar in a bowl, add the carrot and leave to marinate for 20 minutes.

2. Put the rice noodles in a large heatproof bowl, cover with boiling water and leave to soak for 2 minutes or until softened.

Rinse under cold running water, drain well and toss with the oil.

Season with sea salt.

3. Drain the carrot and add to the noodles with the prawns, cucumber, mint and cashew nuts.

4. To make the dressing, put all the ingredients in a blender and whiz until smooth. This dressing can be stored in the fridge for 2–3 days.

5. Add chilli dressing to the salad (as much as you like) and toss gently. Serve with lime wedges.

eat well

Crisp-skinned salmon salad with green goddess dressing Serves 4 1 pink grapefruit 4 x 120g salmon fillets, with skin 1 tablespoon extra virgin olive oil 100g green beans, topped Green goddess dressing Large handful watercress leaves 100g yoghurt 2–3 tablespoons mayonnaise 2 spring onions, chopped

Large handful mixed herbs (such as dill, basil, mint and parsley) Juice of ½ lemon To serve 2 large handfuls watercress leaves Large handful flat-leaf parsley Large handful mint 1 ripe avocado, sliced Sea salt

1. Segment the grapefruit by first slicing off both ends. Stand the fruit on a board and, following its curve, slice off the peel and pith with a very sharp knife. Cut out the grapefruit segments by slicing between the membranes.

2. Heat a frying pan over medium to high heat for 2 minutes. Brush the salmon with oil and season well. Cook the salmon, skin down, for 3 minutes, then turn over and cook for 1 minute; the salmon should be quite rare and the skin crispy. Remove from the pan and leave to rest for 2 minutes.

3. Meanwhile, blanch the beans in a pan of lightly salted boiling water for 2–3 minutes until they are bright green and tender yet crisp. Rinse under cold running water and drain well.

4. To make the dressing, pulse together all the ingredients in a blender or food processor, adding a little more yoghurt or some water if needed. Refrigerate until required.

5. To serve, arrange the watercress, parsley, mint, avocado, beans and grapefruit on plates. Slice the salmon and place on top, drizzle with green goddess dressing and season with sea salt. wellplan > 21

footing Even

The health of our feet can often be overlooked, but, fortunately, some simple care or professional attention is usually all it takes to keep us on our toes.

WORDS CHRIS SHEEDY

Live well

Frequent travellers beware!

Those lovely, plush carpets lining the floors of many hotels are a lot more dangerous than you think.

“Goodness, I’d never consider walking around with bare feet in a hotel room,” says Hayley Uden, Lecturer in Podiatry at the University of South Australia’s School of Health Services.

“Hotel carpet is terrible. Tinea, a fungal infection, is one of the most commonly spread bugs. Any place that others have been barefoot, including change rooms at swimming pools and gyms and especially carpeted areas, is a bad place to be in bare feet.”

Foot care is a great passion for Uden and she hopes that more people will soon come to realise how much podiatrists know about the subject. She says people with foot problems should make a timely appointment with a podiatrist, as most issues are easily solved.

“Some foot issues can be related to a specific health complaint, such as diabetes, which slowly takes away feeling and reduces blood flow to the feet and can have terrible consequences if untreated,” says Uden. “But most foot problems, whether sports related, age related or stemming from badly fitting footwear, can be managed by a podiatrist.”

The usual suspects Understanding and identifying common foot problems is important in order to treat them, says Uden. A bunion, for instance, is a bone protrusion usually affecting the area next to the big toe, which can cause pain, redness, swelling and inflammation at the joint. Calluses and corns are excess layers of skin that have grown to prevent a wound in areas where there’s been increased localised pressure and friction. In-grown toenails cause fairly intense pain around the side of the big toenail and can be red and swollen or infected.

Flat feet, where the arch of the foot appears to have collapsed, were once seen as a major issue. These days, however, they’re understood to be simply something that can cause complications if the person wishes to pursue a certain path, such as professional sport.

Likewise, high arches can also lead to stress fractures and ankle strains in certain situations, but people with these complaints commonly live a perfectly healthy and happy life.

The point, says Uden, is that all these issues – and many others – can be managed

successfully. Medicine and technology have advanced to the point where some foot problems, such as in-grown toenails and calluses, can be resolved in a single visit to the podiatrist.

Care for your feet Prevention, of course, is the best cure. Uden says that, as with most medical issues, women are far more likely than men to seek professional help. And in the community, it is the elderly who know the most about the skills of podiatrists.

“But it’s not only the elderly who benefit from our help,” says Uden. “Common and easily managed sport injuries include sprains, strains, ankle pain, pain under the ball of the foot and pain from badly fitting shoes. So many issues can be easily managed simply through advice on what type of shoes to wear.”

Uden also offers some simple ‘at-home’ advice for foot care. “When you’re cutting

6 foot-care top

tips

your toenails, follow their natural contour then file any sharp corners. Toenails grow more slowly than fingernails, so you don’t have to cut them as often. Moisturiser can be excellent for feet as it protects the skin’s elasticity – without moisturiser, especially in summer when you’re often wearing open shoes in the sun, your skin can dry out, harden and crack. Normal body moisturiser is fine but also check the foot section at your local pharmacy for stronger products. And never moisturise between your toes.”

When it comes to shoes and socks, Uden says natural fibres that give and breathe are preferable.

“Finally,” she says, “if you must be barefoot then stay away from areas in which others are also not wearing shoes. The number of kids we see at the beginning of each year with warts, because swimming lessons have begun, is quite amazing. Shoes don’t just protect from injury, they can help protect from infection, too.”

3

Wear natural fabrics as much as possible, such as cotton socks and leather shoes.

4

If your feet are sweaty or emit odour, change socks and shoes as often as possible, and look into various powders that are available.

5

Steer clear of medicated corn treatments, which, without the right advice, can cause harm.

6

The podiatrist should be your first port of call when you have a foot problem. Never try to treat yourself.

Podiatry expert Hayley Uden offers essential advice regarding the health of your feet.

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Tight shoes are the enemy, especially for sport and work. Avoid shoes that rub uncomfortably.

Moisturiser is excellent for your feet, but keep it away from between your toes.

wellplan > 23

Hot Topic

Taking

heart

One Australian woman dies of a heart attack every two hours1, yet many women do not know they’re at risk – or even how to recognise the warning signs.

WORDS Ian Neubauer

24 > wellplan

If you think heart disease isn’t a problem for women, think again. According to the Heart Foundation of Australia, it’s the number one killer of women in Australia and claims four times as many victims as breast cancer every year2. In fact, the Heart Foundation points out that a female is just as likely to die from a heart attack as a male1.

The good news is that many of the risk factors are manageable, meaning you can help prevent heart disease by leading a healthy lifestyle: eating low-fat foods, exercising regularly, maintaining a healthy weight, monitoring your cholesterol and blood pressure, and not smoking.

Being able to recognise the warning signs of a heart attack is also vital – the Heart Foundation says people treated within an hour of their first heart attack symptom have the greatest chance of surviving.

These warning symptoms vary from person to person and may not be sudden

rewards

or severe. For many women, the typical signs of crushing chest pain and dramatic collapse can be far less pronounced or even completely absent, while other symptoms like shortness of breath, weakness, cold sweats, dizziness, pain in the jaw or back and nausea are often more common.

“The Hollywood heart attack isn’t real for most people,” explains Professor James Tatoulis, a practising cardiologist at The Royal Melbourne Hospital. “For women, it more often starts with a heaviness in the chest that radiates up the arm and into the jaw, and that becomes progressively worse over five to 15 minutes. Some say it feels like an elephant standing on your chest.

“In that case, you should definitely call an ambulance. My message is you can die from a heart attack, not from the embarrassment of calling an ambulance if it’s a false alarm.”

While waiting for an ambulance, Professor Tatoulis recommends lying down and taking an aspirin as soon as possible. Aspirin acts as a blood thinner, thereby reducing the risk of a life-threatening clot in the heart’s arteries.

“Aspirin is a significant part of ongoing treatment for people with coronary artery disease,” adds Professor Tatoulis.

References: 1 National Heart Foundation of Australia, heartattackfacts.orgau/heart-attack-facts 2 National Heart Foundation of Australia, heartfoundation.org.au/your-heart/womenheart-disease/

Changes to Australian Unity member rewards Rewarding our members with more than just exceptional health cover has always been important to Australian Unity.

Get set for some changes to our Rewards program. Once in place, the improved program will give you the opportunity to tell us what you want, so we can deliver rewards that are more tailored to your interests.

Help for members with

Member benefit

heart disease

Australian Unity members suffering from coronary artery disease may qualify for Australian Unity’s Coronary Artery Disease Program*. A free telephone service run by a team of Accredited Practising Dietitians, the program dispenses information and offers counselling on diet, physical activities, medications and cardiovascular risk factors, such as high cholesterol and diabetes.

To find out more, call Australian Unity on 13 29 39.

For information on heart attacks, visit heartattackfacts.org.au or call 1300 362 787.

After all, our members are always the core focus at Australian Unity. And that means not only providing you with great value health cover and excellent service, but also rewarding you with additional benefits.

We’re excited about the coming changes and we hope that you will be, too.

Stay tuned for all the details, which will be unveiled in the coming months, as we continue to offer rewards that best suit your needs and interests.

*To be eligible for the program, you must have been diagnosed with coronary artery disease and/or had a cardiac event such as a heart attack, angioplasty or insertion of a stent. Available with all Hospital and Combination covers except Budget Hospital, Care ’n Repair, Smart Start and Overseas Visitors Cover. Terms of particular cover apply, including 12-month membership waiting period.

wellplan > 25

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Made any changes lately?

PP349181/00249

Have you moved house recently? Or changed your mobile phone number or email address? Simply by logging onto Online Member Services, you can update your contact details so that we can keep in touch.

With your current mobile phone number on our records, we can notify you by SMS as soon as your Extras claim is approved (when you send in a claim via mail). It also means we can contact you immediately, should the need ever arise.

If your electronic contact details are up to date, we can send you the latest information about your health cover products and services via email; not only will this give you instant access to important updates, but you’ll also be helping the environment by cutting back on paper waste.

And, by ensuring we have your current postal address, you won’t miss out on any important information we may send you from time to time.

Update your details in one of three ways: 1 Online Member Services… it’s quick and easy! Simply login or register at australianunity.com.au/memberservices and click through to ‘Change your contact details’ from the ‘My Membership Details’ tab.

2 Call us on 13 29 39.

3 Complete the form below and mail to Health Membership, Australian Unity, Reply Paid 64466, Melbourne, VIC 8060 (no stamp required).

Change of details form Membership Number

Name

Residential Address

Suburb State Postcode

Postal Address (If different from above)

If undelivered, please return to: 114 Albert Rd South Melbourne VIC 3205

print po s t

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Suburb State Postcode

Telephone (home)

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(work)