Care Options and References for a Healthier Life
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For 20 years, CARE magazine has been a trusted read for heathly options and references. More and more loyal readers have requested access to our timely articles presented in the printed edition. With that in mind, we have made the decision to expand our footprint and have pledged to grow our publication via the web. Explore and enjoy the new version of our popular magazine, presented in a professional, easy-to-navigate digital format at www.caremagazine.com.
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AUTUMN 2016
Autumn
care 2016 magazine ®
In this issue 4
Artificial sweeteners may increase your hunger
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Couch potato– smaller brain?
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What are bio-identical hormones?
15
Popular heartburn pills may be risky
18
Prepare for flu season
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CareTALK© - capsules of healthy information
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Does super-sizing start with baby bottles?
27
Pros and Cons to detox cleanse diets
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Healthy recipes: Grape Ideas! Four wholesome, healthy recipes your family will love
AUTUMN 2016
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care magazine
®
Tai Chi as Effective as Physical Therapy for Knee Osteoarthritis Tai Chi is at least as effective as physical therapy for treating knee osteoarthritis, according to a randomized trial in the Annals of Internal Medicine.
Options and References for Healthier Living
AUTUMN 2016 Publisher and Editor:
Karen Mozzo
Associate Editors:
Jan Gernon Rose Ewing Elizabeth Dardes
Website Manager:
CyberZoo Ltd.
Some 200 adults aged 40 or older with knee osteoarthritis were randomized to Tai Chi or physical therapy. Tai Chi included two group sessions weekly for 12 weeks, while physical therapy involved two outpatient sessions weekly for 6 weeks followed by continued home exercises for 6 weeks.
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The bottom line? Standardized Tai Chi should be considered as an effective therapeutic option for knee osteoarthritis.” — JWatch.org
editor@caremagazine.com www.caremagazine.com
What is Restless Legs Syndrome (RLS) and is there a cure for it?
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We’ve all experienced abnormal sensations in our legs at one time or another, but for as many as 10 percent of the US population, restless legs syndrome (RLS) is a daily occurrence. Characterized by throbbing, pulling, tingling, itching, and crawling sensations, RLS is a neurological disorder that produces unpleasant physical sensations in the extremities and an urge to counteract that sensation by movement.
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source only, not as a guide to self-treatment. Information contained within is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You, the reader, assume full responsibility for how you choose to use this information. Guest columns or advertisements do not necessarily reflect the views or opinions of care magazine , its publisher or editors. ®
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At 12 weeks, both groups saw significant reductions in a 500-point osteoarthritis index measuring pain with Tai Chi and 143 with physical therapy; the difference between groups was not significant. The Tai Chi group had significantly greater improvements in depression and quality-of-life scores. In both groups, treatment effects persisted to 52 weeks.
RLS occurs in both men and women, but according to statistics from the National Institutes of Health, “the incidence is about twice as high in women.” The prevalence of RLS in the general population is higher than —continues on next page most people realize.
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AUTUMN 2016
—continued from previous page
In fact, the cause of RLS can be elusive in the general population as well. The primary form occurs for unknown reasons, but according to research studies there may be an underlying genetic factor to the disease. The secondary form of RLS is the result of a medical condition or side effect from a medication (most often antidepressants, anticonvulsants, and beta blockers). Conditions linked to secondary RLS include: irondeficiency anemia, peripheral neuropathy (damage to the nerves of the extremities, often due to diabetes), thyroid conditions, kidney failure, vitamin deficiencies, fibromyalgia and varicose veins. Source: Society for Women’s Health Research (SWHR)
Did you know?
A prediabetes diagnosis means you have higher than normal blood glucose levels, but not high enough to be considered diabetes. Excessive glucose in the blood can damage the body over time, and those diagnosed with prediabetes are at risk for developing type 2 diabetes, heart disease and stroke. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the majority of people with prediabetes do not have any symptoms. The condition is typically revealed after blood tests indicate blood glucose levels are higher than normal. Being overweight and living an inactive lifestyle are two of the biggest risk factors for prediabetes, and doctors may recommend that men and women 45 and older, especially those who are overweight, be tested for prediabetes. Those who have been diagnosed with prediabetes will not necessarily develop diabetes down the road. In fact, the NIDDK notes that men and women who lose at least 5 to 10 percent of their starting weight can prevent or delay the onset of diabetes and may even be able to reverse prediabetes. AUTUMN 2016
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Do
Artificial Sweeteners Actually Increase Your Hunger?
Artificial sweeteners are in just about everything. Researchers say artificial sweeteners have an effect on how the brain regulates appetite as well as on the taste perceptions in our mouth. “Artificial sweeteners can actually change how animals perceive the sweetness of their food, with a discrepancy between sweetness and energy levels prompting an increase in caloric consumption,” said researchers from the Garvan Institute and the Charles Perkins Centre at the University of Sydney, Australia. Their study was published (June 2016) in the journal Cell Metabolism. In the study, scientists first laced fruit flies’ diet with the artificial sweetener sucralose for more than five days. Those flies consumed 30 percent more calories than they did when they were given naturally sweetened foods. The researchers then performed the same experiment using mice. They discovered that the mice given an artificially sweetened diet experienced a “significant increase in food consumption.” When they investigated why animals were eating more even though they had enough calories, they found that chronic consumption of this artificial sweetener actually increases the sweet intensity of real nutritive sugar, and this then increases the animal’s overall motivation to eat more food.
To help push this response along, the brain enhances the flavor of certain foods, the researchers said. Using this response to artificially sweetened diets, they were able to functionally map a new neuronal network that balances food’s palatability with energy content. The pathway they discovered is part of a conserved starvation response that actually makes nutritious food taste better when you are starving. The researchers also concluded artificial sweeteners promoted hyperactivity, insomnia, and decreased sleep quality, which can all be noted when people are fasting or in mild starvation mode.
Other potential explanations There are other possible explanations for the increased calorie consumption as well as other things to consider. The study noted that • many people who begin consuming artificial sweeteners are overweight or obese, and may already be taking in a lot of calories. • people are unique, so individual brains may react differently to artificial sweeteners. • Genetics also plays a role in obesity.
Why this may happen The researchers say they uncovered a neural map that explains the extra calorie consumption. They say this neuronal network responds to artificial sweeteners by telling animals (and that includes humans) that they haven’t consumed enough energy. The researchers concluded that inside the brain’s reward centers, sweet sensations are integrated with energy content. When sweetness and energy are out of balance for a period of time, the brain recalibrates and sends out signals for more calories to be consumed.
AUTUMN 2016
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Drinking water, is one of the best ways to lose weight and reduce sugar consumption
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Silent Strokes Can Jeopardize Memory The symptoms of a stroke are sometimes obvious, like numbness or weakness on one side of the face, trouble speaking, difficulty walking, and vision problems. Some strokes, though, pass completely unnoticed. But even these can have a significant and lasting effect on memory.
These so-called silent strokes create pinpoints of dead cells in the brain. The damaged areas are smaller than with a traditional stroke, and often don’t affect areas of the brain associated with movement or speech.
During a typical ischemic stroke, a blood clot blocks a blood vessel that feeds part of the brain. Without a steady supply of blood, cells in that area malfunction and may die. Symptoms that appear reflect the functions that were controlled by the affected part of the brain. A hemorrhagic stroke caused by a burst blood vessel does the same thing.
During a silent stroke, the interruption in blood flow occurs in part of the brain that doesn’t control any vital functions. Although it doesn’t cause any obvious symptoms—most people who’ve had a silent stroke have no idea it occurred—however, the damage does show up on an MRI or CT scan.
Silent strokes could interrupt the flow of information in the brain needed for memory, 8
especially if several of these strokes occur over time (which is the most common scenario). Damage from silent strokes can accumulate, leading to more and more memory problems.
What can you do when faced with a stroke that has no symptoms, and that can only be found on an MRI or CT scan?
Manage the risk factors! This means:
! control your blood pressure and diabetes
! do not smoke ! keep your cholesterol levels in check ! aim for and maintain a healthy weight ! manage atrial fibrillation If you are experiencing signs of memory loss, don’t dismiss it as a normal part of aging. See your doctor for testing to make sure the issue isn’t a silent stroke.
Source: Harvard Women’s Health Watch, www.harvardhealth.edu
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AUTUMN 2016
Here's something to jolt you off the couch and get you exercising: A study published Feb. 10, 2016, in Neurology links poor fitness levels in middle age to brain shrinkage 20 years later. Researchers, including some from Harvard Medical School, looked at the cardiovascular fitness of about 1,100 people, average age of 40, who were free of dementia and heart disease. The participants had taken treadmill tests to determine their cardiovascular fitness levels based on how much oxygen their bodies used during exercise.
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COUCH POTATO Smaller Brain? About 20 years later, participants took another treadmill test and underwent neuropsychological testing and MRI brain scans. The scans showed that people who were unfit in middle age had smaller brains in older age, compared with people who were fit in middle age. This doesn't prove that inactivity in midlife causes brain shrinkage. But previous studies have shown that regular, moderate-intensity exercise may be associated with slower brain aging. Source: http://www.health.harvard.edu/stayinghealthy/couch-potato-in-midlife-smaller-brain-later AUTUMN 2016
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Higher intakes of boiled, baked, or mashed potatoes, and French fries is associated with an increased risk of developing high blood pressure (hypertension) in adult women and men.
more about potatoes . . .
Higher potato consumption associated with increased risk of high blood pressure
The US-based researchers suggest that replacing one serving a day of boiled, baked, or mashed potatoes with one serving of a non-starchy vegetable is associated with a lower risk of developing hypertension.
Potatoes are one of the world’s most commonly consumed foods—and have recently been included as vegetables in US government healthy meals programs, due to their high potassium content. But the association of potato intake with hypertension had not been studied. So researchers based at Brigham and Women’s Hospital and Harvard Medical School set out to determine whether higher long term intake of baked, boiled, or mashed potatoes, French fries, and potato chips was associated with incident hypertension.
Four or more servings a week of baked, boiled, or mashed potatoes was associated with an increased risk of hypertension compared with less than one serving a month in women, but not in men.
They followed over 187,000 men and women from three large US studies for more than 20 years. Dietary intake, including frequency of potato consumption, was assessed using a questionnaire. Hypertension was reported by participants based on diagnosis by a health professional.
After taking account of several other risk factors for hypertension, the researchers found that four or more servings a week of baked, boiled, or mashed potatoes was associated with an increased risk of hypertension compared with less than one serving a month in women, but not in men. Higher consumption of French fries was also associated with an increased risk of hypertension in both women and men. However, consumption of potato chips (crisps) was associated with no increased risk. After further analyses, the researchers suggest that replacing one serving a day of boiled, baked, or mashed potatoes with one serving of a non-starchy vegetable is associated with a decreased risk of hypertension.
The study authors point out that potatoes have a high glycaemic index compared with other vegetables, so can trigger a sharp rise in blood sugar levels, and this could be one explanation for the findings.They also acknowledge some study limitations and say that, as with any observational study, no firm conclusions can be drawn about cause and effect.
Nevertheless, they say their findings “have potentially important public health ramifications, as they do not support a potential benefit from the inclusion of potatoes as vegetables in government food programs but instead support a harmful effect that is consistent with adverse effects of high carbohydrate intakes seen in controlled feeding studies.” Source: British Medical Journal ( BMJ). Note: Materials may be edited for content and length. Abstracted from www.sciencedaily.com/releases/2016/05/160517191803.htm 10
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AUTUMN 2016
About High Blood Pressure Medicines There are several types of medicine used to treat high blood pressure. Your doctor will decide which type of medicine is right for you. Alpha blockers help relax your blood vessels by reducing nerve impulses. This allows your blood to pass through more easily. Alpha-beta blockers not only reduce nerve impulses, but also make the heart beat slower so the blood passes through the vessels with less force. They combine the effects of beta blockers and alpha blockers. Angiotensin-converting enzyme inhibitors (also called ACE inhibitors) keep your body from making angiotensin II, a hormone that causes blood vessels to narrow. This relaxes your blood vessels. Angiotensin II receptor blockers (also called ARBs) relax your blood vessels by blocking the effects of angiotensin II, a hormone that causes blood vessels to narrow. Beta blockers make the heart beat slower so that blood passes through your blood vessels with less force. Calcium channel blockers (also called CCBs) help keep your blood vessels from constricting (becoming narrow) by blocking calcium from entering your cells. Centrally acting drugs affect your brain and central nervous system to reduce the nerve impulses that can increase your heart rate and cause your blood vessels to narrow. Direct vasodilators relax the muscles in the blood vessel walls. This causes the blood vessels to widen. Diuretics (water pills) help your body get rid of extra sodium (salt) and water so your blood vessels don't have to hold so much fluid. Renin inhibitors slow down your body’s production of renin, the enzyme that starts the many chemical reactions that raise your blood pressure. AUTUMN 2016
Do these medicines have any side effects? All medicines can have side effects. Some possible side effects of high blood pressure medicines include the following: • Chest pain, heart palpitations (the feeling that your heart is racing) or arrhythmia (irregular heartbeat) • Cough, fever, congestion, upper respiratory tract infection, or "flu-like" symptoms • Diarrhea or constipation • Dizziness or lightheadedness • Headache • Nausea • Nervousness or increased anxiety • Problems with erections and sexual function • Skin rash • Tiredness, weakness, drowsiness or lethargy (lack of energy) • Unintended weight loss or gain • Vomiting Tell your doctor as soon as possible if your side effects become severe or bothersome.
What is a drug interaction? If you use 2 or more drugs at the same time, the way your body processes each drug can change. When this happens, the risk of side effects from each drug increases and each drug may not work the way it should. This is called a "drug-drug interaction." Vitamins and herbal supplements can also affect the way your body processes medicine. Certain foods or drinks can also prevent your medicine from working the way it should or make side effects worse. This is called a "drug-food interaction." For example, people taking certain CCBs may need to avoid eating grapefruit or drinking grapefruit juice. Be certain that your doctor knows all of the over-thecounter and prescription medicines, vitamins, and herbal supplements you are taking. Also, ask your doctor whether you need to avoid any foods or drinks while using your blood pressure medicine.
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Source: http://familydoctor.org 11
What are Bioidentical Hormones? Bioidentical hormones are identical to the hormones that women make in their bodies. (Other types of hormone therapy, like the one used in the WHI study, differ slightly from the hormones made in the body.) Bioidentical hormones are sometimes called “natural” hormones—even though they are made in a laboratory—because they come from plant sources before being altered to be like human hormones. Not all hormones made from natural sources are bioidentical. There are two types of bioidentical hormone products: • Pharmaceutical products. These products
have been approved by the U.S. Food and Drug Administration (FDA). Their quality and safety is regulated so it is the same high quality product every time.
• Custom-made products. When many people
think of bioidentical hormones, they think of custom-made products. These are made in a compounding pharmacy (a pharmacy that mixes medications according to a doctor’s instructions). These products may contain varying amounts of two or three types of estrogen, often mixed with other hormones. Although the individual ingredients are approved by the FDA (except for estriol), the compounds themselves (the final product after the ingredients are combined) are not. Because these compounds are not regulated by the FDA, they can be of low quality. The amount of hormone can change with each batch. Most menopause specialists start with FDAapproved products because they’ve been proven 12
to be safe and effective. For women who cannot take these products due to allergies, or who need a special prescription, custom-made products are an option. Because the quality of custom-made products can vary, however, it is safer to use pharmaceutical products. This way, you’ll know exactly what you’re getting and how much.
Are bioidentical hormones safer to use than other forms of hormone therapy?
To date, there is no scientific proof that bioidentical hormones, whether prepared by a compounding pharmacy or pharmaceutical company, are safer to use than other forms of HT. All forms of HT may have potential risks, whether compounded or pharmaceutical, bioidentical or not.
How will you know what is best for you?
Menopause is a natural stage in a woman’s life. Some symptoms such as hot flashes can go away in a few years. Others, such as vaginal dryness, often do not go away. Many treatment options exist for problems that come with menopause. Your doctor can help you choose the best treatment for you. Treatment will be based on your medical history and your risk of health problems such as breast cancer, stroke, heart disease, and blood clots. It will also depend on the symptoms you want to treat (such as vaginal dryness only or symptoms that affect your whole body). If your doctor prescribes HT, the FDA recommends using the lowest possible dose for the shortest time needed to relieve symptoms. The idea is to avoid
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AUTUMN 2016
taking too much medication for too long to reduce potential risks linked to HT. You might also want to consider the wide range of non-hormonal options available to treat menopausal symptoms.
Resources • `Find-an-Endocrinologist: www.hormone.org or call 1-800-HORMONE (1-800-467-6663) • Hormone Health Network information about menopause www.hormone.org/Menopause www.hormone.org/MenopauseMap
Finding the type of treatment that works best for you may take some time. Whatever you choose, your doctor will monitor your therapy regularly.
• MedlinePlus (National Institutes of Health): www.nlm.nih.gov/ medlineplus/hormonereplacementtherapy.html • Mayo Clinic: www.mayoclinic.com/health/ hormonetherapy/WO00046 www.mayoclinic.com/health/bioidenticalhormones/AN01133
Questions to ask your doctor • Do I need hormone therapy?
• What are my options for therapy?
• U.S. Food and Drug Administration information about bioidentical hormones: www.fda.gov/ForConsumers/ ConsumerUpdates/ucm049311.htm
• What are the risks and benefits of each option?
• Women’s Health Initiative (U.S. Department of Health and Human Services): www.nhlbi.nih.gov/whi/
• How long will I need therapy?
• Should I consider non-hormonal treatment?
• Should I see an endocrinologist?
• North American Menopause Society: www.menopause.org Source: Hormone Health Newtork www.hormone.org
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A gene that scientific dogma insists is inactive in adults actually plays a vital role in preventing the underlying cause of most heart attacks and strokes, researchers at the University of Virginia School of Medicine have determined. The discovery opens a new avenue for battling those deadly conditions, and it raises the tantalizing prospect that doctors could use the gene to prevent or delay at least some of the effects of aging.
likely to rupture. The researchers also have provided evidence that the gene promotes many changes in gene expression that are beneficial in stabilizing the plaques. This is exciting, because studies suggest that it may be possible to develop drugs or other therapeutic agents that target the Oct4 pathway as a means to reduce the incidence of heart attacks or stroke. Their findings have major implications regarding possible new therapeutic approaches for promoting stabilization of atherosclerotic plaques. One surprising finding from UVA’s research: When the researchers blocked the effect of Oct4 in mice, they thought the atherosclerotic plaques might become smaller, because of the reduced number of smooth muscle cells inside. Instead, the plaques grew larger, less stable and more dangerous, stuffed with lipids, dead cells and other damaging components.
Gene Helps Prevent Heart Attack, Stroke – And May Offer Way to Block Effects of Aging Advancing Regenerative Medicine
While UVA’s research has focused on how Oct4 offers cardiovascular protection, the researchers believe the gene could also prove critical to the field of regenerative medicine, which investigates the growth and replacement of tissues and organs. They believe that Oct4 and its family of target genes are activated in other somatic cells—the non-reproductive cells in the body— and play a key role in the cells’ ability to repair damage and heal wounds. Studies to test this are under way.
Unexpected Protective Effect
The gene, Oct4, plays a key role in the development of all living organisms, but scientists have, until now, thought it was permanently inactivated after embryonic development. Some controversial studies have suggested it might have another function later in life, but the UVA researchers are the first to provide conclusive evidence of that. These UVA researchers have determined the gene plays a critical protective role during the formation of atherosclerotic plaques inside blood vessels. The rupturing of these plaques is the underlying cause of many heart attacks and strokes. The researchers found that Oct4 controls the movement of smooth muscle cells into protective fibrous “caps” inside the plaques—caps that make the plaques less 14
Oct4 is one of the “stem cell pluripotency factors” described by Shinya Yamanaka, MD, PhD, for which he received the 2012 Nobel Prize. His lab and many others have shown that artificial over-expression of Oct4 within somatic cells grown in a lab dish is essential for reprogramming these cells into induced pluripotential stem cells, which can then develop into any cell type in the body or even an entire organism. The UVA researchers suspect that at least some of the detrimental effects of aging, including the increased possibility of a plaque rupture, stem from a decrease in the body’s ability to reactivate Oct4. ” Source: University of Virginia Health System Journal reference: dx.doi.org/10.1038/nm.4109
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AUTUMN 2016
Popular Heartburn Pills May Be Risky
Proton pump inhibitors (PPIs) are a class of drugs used to treat heartburn, gastroesophageal reflux disease (GERD), and gastric ulcers. Popular, recognizable names of PPIs currently on the market include Nexium, Prilosec, or Prevacid. Heartburn and GERD are quite common. Heartburn is the main symptom of GERD but does not always signal it. There’s an ongoing coverage of risks associated with taking proton pump inhibitors (PPIs) and medications containing aspirin for heartburn relief. A recent Harvard Health story stresses consumers be cautious of a long-term relationship with PPIs for fear of side effects.
PPIs work by blocking production of stomach acid. And that could be the root of the problem, according studies. Stomach acid helps digest food and also has a “barrier function against different pathogens which are ingested. So when there’s less stomach acid, it leaves people vulnerable to nutritional deficiencies and infections, including food poisoning like salmonella, a serious, sometimes life threatening digestive system infection called Clostridium difficile, and perhaps pneumonia. Stomach acid also helps digest food. If you don’t have any of that acid, it can make it hard to get the vitamins, minerals and other nutrients you need from your food— including nutrients that keep bones strong and prevent fractures.
Illustration credit:Wikimedia.org
In addition, one recent study suggested people who continually take PPIs may be at greater risk of heart disease; These drugs could increase the risk for chronic kidney disease, dementia and decreased B12 levels. Also, the FDA just released a warning saying aspirin-containing antacid medicines can cause bleeding.
The risks keep coming but the heartburn isn’t going away. According to recent figures shared by the American College of Gastroenterology, a staggering 60 million American adults experience acid indigestion or heartburn at least once a month, while more than 15 million experience it daily.
Many people take PPIs when they don’t really need them. They could get rid of their heartburn by making lifestyle changes such as losing weight and cutting back on alcohol, caffeine and spicy and fatty foods. Many people take them a lot longer than they need them. PPIs are usually taken for two to eight weeks, although doctors may recommend a longer course.
So where can the 60 million heartburn sufferers turn to get relief without the risks? There are tried and true over-the-counter (OTC) remedies like Maalox, Gaviscon, Rolaids, Tumsor Mylanta. AUTUMN 2016
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If you’ve ever rubbed a topical pain reliever—a cream, gel or other product applied to the skin—on a sore muscle or joint, you’re familiar with the sensation of warmth or coolness that soon follows. But if, instead, you experience burning pain or blistering, you must seek medical attention immediately. The Food and Drug Administration (FDA) is warning that some consumers have reported receiving serious skin injuries while using certain over-the-counter (OTC) pain relievers applied to the skin to relieve mild muscle and joint pain. The injuries, while rare, have ranged from mild to severe chemical burns with use of such brand-name topical muscle and joint pain relievers as Icy Hot, Bengay, Capzasin, Flexall, and Mentholatum.
Topical Pain Relievers May Cause Burns
OTC topical pain relievers for muscles and joints include creams, lotions, ointments and patches. In many cases, burns where the product was applied occurred after just one application, with severe burning or blistering occurring within 24 hours. Some had complications serious enough to require hospitalization. “There’s no way to predict who will have this kind of reaction to a topical pain reliever for muscles and joints,” says Jane Filie, M.D., a medical officer in FDA’s Division of Nonprescription Regulation Development (DNRD).
Safety Do’s and Don’ts FDA has the following advice for consumers using OTC topical muscle and joint pain relievers:
•
Don’t apply these products onto damaged or irritated skin.
•
Don’t apply bandages to the area where you’ve applied a topical muscle and joint pain reliever.
•
Don’t apply heat to the area in the form of heating pads, hot water bottles or lamps. Doing so increases the risk of serious burns.
•
Don’t allow these products to come in contact with eyes and mucous membranes (such as the skin inside your nose, mouth or genitals).
It’s normal for these products to produce a warming or cooling sensation where you’ve applied them. But if you feel actual pain after applying them, look for signs of blistering or burning. If you see any of these signs, stop using the product and seek medical attention. If you have any concerns about using one of these products, talk to a medical professional first. Report unexpected side effects from the use of OTC topical pain reliever to the FDA MedWatch program
Source: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm318674.htm 16
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AUTUMN 2016
Foods That May Help Fight the Risk of Chronic Inflammation A recent University study has identified food stuffs that can help prevent chronic inflammation that contributes to many leading causes of death.
Little is known about the relative potency of different (poly)phenols in modulating cytokine release by lymphocytes.
Inflammation occurs naturally in the body but when it goes wrong or goes on too long, it can trigger disease processes. Uncontrolled inflammation plays a role in many major diseases, including cancer, heart disease, diabetes and Alzheimer’s disease.
Pro-inflammatory mediators
Diets rich in fruits and vegetables, which contain polyphenols, protect against agerelated inflammation and chronic diseases.
Sian Richardson, said: “The results of our study suggest that (poly)phenols derived from onions, turmeric, red grapes, green tea and açai berries may help reduce the release of pro-inflammatory mediators in people at risk of chronic inflammation.
Cell-to-cell communication Polyphenols are abundant micronutrients in our diet, and evidence for their role in the prevention of degenerative diseases such as cancer and cardiovascular diseases is already emerging. The health effects of polyphenols depend on the amount consumed and on their bioavailability. T-cells, or T-lymphocytes, are a type of white blood cell that circulate around our bodies, scanning for cellular abnormalities and infections. They contribute to cell signalling molecules (cytokines) that aid cell-to-cell communication in immune responses and stimulate the movement of cells towards sites of inflammation, infection and trauma. Cytokines are modulated by fruit and vegetable intake.
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The study, conducted by Sian Richardson and Dr Chris Ford from the University’s Institute of Ageing and Chronic Disease, examined the different potencies of the polyphenols.
“Older people are more susceptible to chronic inflammation and as such they may benefit from supplementing their diets with isorhamnetin, resveratrol, curcumin and vanillic acid or with food sources that yield these bioactive molecules.” The study, entitled ‘Identification of (poly)phenol treatments that modulates the release of proinflammatory cytokines by human lymphocytes’, has been published in the British Journal of Nutrition and can be found here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836295/
Source materials provided by University of Liverpool Journal reference: dx.doi.org/10.1017/S0007114516000805
SOCIAL SECURITY
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NO FEE UNLESS YOUR CASE IS WON! Toll Free: 1-888-306-7390 Serving the Lowcountry
Harry Ammon, Lowcountry regional Instructor
843-521-1941 AUTUMN 2016
843-521-0652 69 Robert Smalls Pkwy., Landmark Bldg., Suite 1B, Beaufort, SC Email: swierkassoc@hargray.com
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Prepare for the FLU season The 2015–2016 U.S. flu season was milder than the past three seasons and peaked later than usual, according to a CDC analysis of influenza activity in MMWR.
What sort of flu season is expected this year?
It’s not possible to predict what this flu season will be like. While flu spreads every year, the timing, severity, and length of the season varies from one year to another. Will new flu viruses circulate this season?
Flu viruses are constantly changing so it's not unusual for new flu viruses to appear each year. For more information about how flu viruses change, visit How the Flu Virus Can Change http://www.cdc.gov/flu/about/viruses/change.htm. When will flu activity begin and when will it peak?
The timing of flu is very unpredictable and can vary in different parts of the country and from season to season. Seasonal flu viruses can be detected yearround, however, seasonal flu activity can begin as early as October and continue to occur as late as May. Flu activity most commonly peaks in the United States between December and March. 18
Protective Actions
What should you do to protect yourself from flu this season?
CDC recommends a yearly flu vaccine for everyone 6 months of age and older as the first and most important step in protecting against this serious disease.
In addition to getting a seasonal flu vaccine, you can take everyday preventive actions like staying away from sick people and washing your hands to reduce the spread of germs. If you are sick with flu, stay home from work or school to prevent spreading flu to others. In addition, there are prescription medications called antiviral drugs that can be used to treat influenza illness. Visit http://www.cdc.gov/flu/antivirals/ whatyoushould.htm for more information. When should you get vaccinated?
Getting vaccinated before flu activity begins helps protect you once the flu season starts in your community. It takes about two weeks after vaccination for the body’s immune response to fully respond and for you to be protected so make plans to get vaccinated. CDC recommends that people get a flu vaccine by the end of October, if possible. However, getting vaccinated later can still be beneficial. CDC recommends ongoing flu vaccination as long as influenza viruses are circulating, even into January or later. Children aged 6 months through 8 years who
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need two doses of vaccine should get the first dose as soon as possible to allow time to get the second dose before the start of flu season. The two doses should be given at least 28 days apart.
How long does a flu vaccine protect you from getting the flu?
Multiple studies conducted over different seasons and across vaccine types and influenza virus subtypes have shown that the body’s immunity to influenza viruses (acquired either through natural infection or vaccination) declines over time. The decline in antibodies is influenced by several factors, including the antigen used in the vaccine, the age of the person being vaccinated, and the person's general health (for example, certain chronic health conditions may have an impact on immunity). When most healthy people with regular immune systems are vaccinated, their bodies produce antibodies and they are protected throughout the flu season, even as antibody levels decline over time. Older people and others with weakened immune systems may not generate the same amount of antibodies after vaccination; further, their antibody levels may drop more quickly when compared to young, healthy people.
Are there any new FluView interactive applications?
Yes. A new FluView interactive application http://www.cdc.gov/flu/weekly/fluviewinteractive.htm was introduced over the summer that shows the distribution by age group of influenza-positive tests by influenza virus type and subtype or lineage. This application allows users to view laboratory data from multiple seasons and different age groups. Users also can view the chart data by week or cumulatively for the season.
For most people, getting vaccinated each year may provide the best protection against influenza throughout flu season. To read more about the effects of receiving the latest flu vaccine, visit the National Vaccine Information Center, www.nvic.org.
CDC Advisers Recommend Against Use of Nasal Spray Flu Vaccine in 2016-2017 FluMist, a quadrivalent (four-strain) live attenuated (as opposed to inactivated) nasal spray flu vaccine, has been recommended for children as a painless alternative to the inactivated flu vaccine injection. However, for the 2016-2017 flu season, which runs from approximately Oct. 2016 to Mar. 2017, the CDC's Advisory Committee on Immunization Practices (ACIP) voted that the nasal spray should not be used, while continuing to recommend that everyone over 6 months of age be vaccinated against the flu.
According to William Schaffner, MD, an infectious disease specialist and Professor of Preventative Medicine and Medicine at Vanderbilt University Medical Center, FluMist has fallen out of favor because, "To everyone's surprise and increasing consternation, this vaccine has performed quite poorly compared to the injectable vaccine."
The CDC found that the live attenuated flu vaccine was virtually ineffective during the 2015-2016 flu season after FluMist was changed from trivalent (three-strain) to quadrivalent, while the inactivated flu injection was 49% effective against any flu strain.
A Canadian study published in the Annals of Internal Medicine on Aug. 16, 2016, found that a trivalent version of FluMist was 46-58% effective against the virus. AstraZeneca, the manufacturer of FluMist, cited similar effectiveness results and stated that the company was "working with the CDC to better understand its data to help ensure eligible patients continue to receive the vaccine in future seasons in the US." Source: http://www.procon.org/headline.php?headlineID=005320
AUTUMN 2016
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We often think of the heart and brain as being completely separate from each other. After all, your heart and brain are located in different regions of your body, and cardiology and neurology are separate disciplines. Yet these organs are intimately connected, and when your emotions adversely affect your brain, your heart is affected as well.
Managing Your Emotions Can Save Your Heart
The negative impact of emotions when your heart is already vulnerable
There are two kinds of stress that impact your brain. Helpful stress (also known as eustress) can assist you with getting things done by helping you focus your attention. Unhelpful stress (distress), on the other hand, can be so severe that it can lead to fatigue and heart disease.
If you have coronary artery disease (CAD), your heart may be deprived of oxygen. This deprivation, called myocardial ischemia, can occur in as many as 30% to 50% of all patients with CAD. It can be further exacerbated by emotional stress. In fact, if you have any type of heart disease, any strong emotion such as anger may also cause severe and fatal irregular heart rhythms. Expressions like “died from fright” and “worried to death” are not just hyperbole—they are physiologic possibilities. Furthermore, when patients with newly diagnosed heart disease become depressed, that depression increases the risk that a harmful heart-related event will occur within that year.
The negative impact of emotions when you have no heart disease
Of course, stress can have a big effect on your heart even if you don’t have heart disease. Here’s just one example: In 1997, cardiologist Lauri Toivonen and colleagues conducted a study of EKG changes in healthy physicians before and during the first 30 seconds of an emergency call. They saw changes that indicated oxygen deprivation and abnormal heart rhythms. More recent studies have also observed these changes in the setting with stress, anxiety, and depression—all of which are, of course—brain-based conditions. Even in people with no prior heart disease, major depression doubles the risk of dying from heart-related causes.
Cardiac psychology:
Tending to your emotions for your heart’s sake
It is important to control your worry and stress, not just because you will worry less and feel better, but because less worry means less stress for your heart. This applies to the entire range of stressors, from a small episode of acute panic to a larger context such as living through a natural disaster. For all the reasons outlined above, a new emotion-based approach to heart health, called cardiac psychology, is receiving increasing interest. You really can change your brain and get a healthier heart in the process. Here are some ways to get started: 20
Seek professional help. Don’t ignore stress, anxiety, depression, excessive worry, or bouts of anger that overwhelm your life. Seek professional help. If you meet criteria for a diagnosis, treatment can help reduce symptoms, thereby protecting your brain and your heart. Available treatments in cardiac psychology. Aside from more traditional psychiatric treatment and exercise, psycho-educational programs, educational training, stress management, biofeedback, counseling sessions, and relaxation techniques should all be considered before or after a heart-related event.
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Newer treatments such as acceptance and commitment therapy and expressive writing can also be helpful.
Exercise. Physical exercise can help you have a healthier heart and brain—in the right doses. For example, many recent studies have demonstrated that aerobic exercise can help you be more mentally nimble by helping you think faster and more flexibly. Even frail older adults have improved their thinking and overall psychological well-being from exercising for one hour, three times a week. And people in rehabilitation after being diagnosed with heart failure report clearer thinking when their fitness levels improve.As clinical research scientist Michelle Ploughman commented, “exercise is brain food.” Various types of aerobic exercise, including jogging, swimming, cycling, walking, gardening, and dancing, have all been proven to reduce anxiety and depression and to improve self-esteem. This is thought to be due to an increase in blood circulation in the brain, and the fact that exercise can improve the brain’s ability to react to stress.
A starting point for better brain—and heart—health
If you struggle with stress, anger, anxiety, worry, depression, or problems with self-esteem, talk to your primary care physician—or a cardiologist, if you have one. A consultation with a psychiatrist may be very helpful. Together, you can explore which of these potential therapies might best protect your psychological state, your brain, and your heart.
When to see a therapist
Depression is the most common reason men should seek professional help. Many life situations—jobs, relationships—can trigger its trademark symptoms, such as prolonged sadness, lack of energy, and a constant feeling of stress. For older men, it can also be brought on by financial anxiety about retirement, the death of a spouse or friend, or even the loss of independence, like losing the ability to drive. Left unchecked, these feelings could cause other health problems, such as rapid weight loss, insomnia, declining libido, and changes in memory. They may even lead to destructive behavior like alcohol or opioid dependence.
are other places to start besides your primary care doctor, too. For example, many employee health care plans offer confidential help lines where you can ask questions and find therapists in your network. Another source is the National Alliance on Mental Illness Helpline (1-800-950-6264), www.NAMI.org
What to expect
Your therapist should help you establish goals of care and then outline a strategy to meet them. This may include a combination of therapy during regular sessions as well as “homework” to follow in between visits. Weekly visits are typical. Yours may be more or less frequent than that depending on how you respond to the therapy. After your initial treatment sessions, you might return periodically for “booster” visits to prevent a future relapse. Do not give up if you do not feel a strong connection with the first therapist you try, says Dr. Mehta. “Try someone else and do not get discouraged. The goal is to find the right person who can guide you.” While therapy may feel awkward at first, most men soon recognize its value, he adds. “Once they make that connection with a therapist, they are quite receptive to therapy and welcome what it can offer.” –By Matthew Solan, Executive Editor, Harvard Men’s Health Watch http://www.health.harvard.edu/special-health-reports or call Toll free 1-877-649-9457 Srini Pillay, MD, Contributor, http://www.health.harvard.edu/blog/ managing-emotions-can-save-heart-201605099541? utm_source=delivra&utm_medium=email&utm_campaign =BF20160509%2DAnxiety&mid=11067910&ml=144210
How to find a therapist
First, talk with your doctor about your situation, how you feel, and your symptoms. He or she will no doubt know therapists who can help with your specific issues. There AUTUMN 2016
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care TALK © capsules of helpful health information Certain Medications, Psychological Therapy May Help Adults with Binge-Eating Disorder Lisdexamfetamine, cognitivebehavioral therapy (CBT), and second-generation antidepressants may help treat adults with bingeeating disorder, suggests a metaanalysis in the Annals of Internal Medicine. Researchers examined data from 34 trials in which adults with bingeeating disorder were randomized to psychological treatment (e.g., CBT, self-help) versus a waitlist control group, or to medication (with or without psychological therapy) versus placebo. Among the findings: Abstinence from binge eating was significantly more common with therapist-led CBT versus waitlist (59% vs. 11%), with the central nervous system stimulant lisdexamfetamine versus placebo (40% vs. 15%), and with secondgeneration antidepressants (e.g., fluoxetine) versus placebo (40% vs. 24%). Eating-related obsessions and compulsions were reduced significantly with lisdexamfetamine and second-generation antidepressants, compared with placebo. Weight loss was significantly greater with lisdexamfetamine and topiramate than with placebo. Dr. Joel Yager of NEJM Journal Watch Psychiatry points to limitations 22
of the analysis, including the mostly white, female population; some authors’ ties to industry; and lack of long-term data. He concludes, “Within these constraints, clinicians can use this information to advise patients of their options and make clinical decisions.” By Amy Orciari Herman, JWatch.org Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD
FDA Approves New Dry Eye Treatment The US Food and Drug Administration (FDA) approved lifitegrast ophthalmic solution (Xildra/Shire US) for the treatment of signs and symptoms of dry eye disease. The product is the first in a new class of drugs called lymphocyte function-associated antigen 1.
majority were female (76 percent). Patients were randomized equally to receive either Xiidra eyedrops or placebo eyedrops, which were used twice a day for twelve weeks. The studies found that groups treated with Xiidra demonstrated more improvement in both the signs and the symptoms of eye dryness than the groups treated with placebo. The most common side effects of Xiidra include eye irritation, discomfort or blurred vision and an unusual taste sensation (dysgeusia). Dry eye disease does not routinely occur in children. Safety and efficacy in pediatric patients below the age of 17 years has not been studied. See more at: http://www.hcplive.com/ medical-news/fda-approves-new-dry-eyetreatment?utm_source=Informz&utm_ medium=HCPLive&utm_campaign=Breaking_ News_7-12-16#sthash.ylg6A39H.dpuf
The treatment restores patients’ ability to produce normal tears. The chance of experiencing dry eye increase with age and affects about 5 percent of adults ages 30 to 40 and 15 percent of adults over age 65. It is more common in women. Untreated the condition may to lead to pain, ulcers, and corneal scarring. According to the FDA, the safety and efficacy of Xiidra was assessed in over a thousand patients, in four separate, randomized, controlled studies. These studies included patients 19–97 years of age, of which the
Did you know? Rates of myopia have increased around the world. More young people are nearsighted, up an estimated 10 percent from the 1950s. Myopia is pandemic in the U.S., reports the National Eye Institute. Once thought to affect bookish children, nearsighted-ness is now believed to “arise from a lifestyle of not just too much reading or computer viewing, but of too little time outdoors,” says researcher Ian Morgan. Glasses can clear up vision, but exposure to sunlight seems to be the best defense.
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AUTUMN 2016
Colonoscopies: Fasting May Not Be Necessary The overwhelming experience of preparing for colonoscopies may no longer have to be tolerated on an empty stomach. Patients awaiting colonoscopies usually skip all solid foods and maintain a clear-liquid diet while simultaneously taking laxatives the day before the procedure.
A new study reports that people who consumed a limited amount of low-fiber foods were not only happier, but also didn’t suffer any negative effects during their exam.
The researchers found that these patients’ bowels were actually better prepared for the procedure than those who followed traditional clear-liquid diets. Jason Samarasena, MD, assistant clinical professor of medicine, University of California, Irvine, said, “The assumptions about no food on the day before colonoscopy are probably not correct. The clear-liquid diet is very restrictive, and probably too restrictive.” And, although, the American Cancer Society released colonoscopy-screening recommendations at age 50 for most adults, many avoided the procedure altogether because of the grueling preparation that’s needed.
Maintaining a clear-liquid diet had been considered the norm, specifically to keep the colon clear during a colonoscopy and avoid hard or fibrous-like seeds to clog the scope.
But, this new idea of keeping a low-fiber diet was considered equally viable, allowing patients to eat foods that aren’t likely to remain in the bowel and disrupt the intestinal examination, like macaroni and cheese, yogurt, white bread, lunchmeats, and ice cream. To test this hypothesis researchers conducted a study with 83 patients, assigning them to either undergo colonoscopies the day after a clear-liquid diet or after a day in which they ate small numbers of acceptable low-fiber foods.
The patients consumed approximately 1,000 to 1,500 calories from a combination of carbohydrates, fat, and protein. AUTUMN 2016
Results showed more of the patients on the low-fiber diet were “adequately prepared” for a colonoscopy and less tired on the morning of the procedure.
How would eating more food actually clear the bowel?
According to Samarasena, eating just stimulates more bowel movements the day before the procedure thus starting the colon-emptying process.
Also, the low-fiber food easily liquefies in the digestive system, therefore still capable of clearing out of the colon. Researchers explained that patients simply should steer clear of high-fiber foods like vegetables, fruits, nuts, seeds, and grains that are often undigested and can significantly interfere with colon exams.
Officials currently estimate more than 134,000 cases of colorectal cancer to be diagnosed in 2016 alone.
While experts urge patients to speak with their physician before changing their colonoscopy prep, they hope relinquishing the traditional rule of fasting would allow more patients to get screened and improve treatment. –By Amy Jacob for MD magazine http://www.hcplive.com/medical-news/colonoscopiesfasting-may-not-be-necessary?utm_source=Informz
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Parent Pulse
helpful insights and tips for effective parenting
Does Super-Sizing Start With Baby Bottles? As a country, we have a weight problem. A stunning two-thirds of American adults are overweight or obese, putting them at risk of heart disease, diabetes, cancer and all the other health problems obesity brings. While there are myriad reasons we are getting fatter as a nation, one very real and simple one is that our serving sizes are getting bigger. For example, 20 years ago the average serving of French fries was 2.4 ounces and 210 calories; now it’s 6.9 oz and 610 calories. The average soda was 6.5 ounces and 85 calories; now it’s 20 ounces and 250 calories. Our standard portions of bagels, muffins, cookies, movie popcorn, sandwiches, hamburgers, and pasta have literally doubled. We are all about super-sizing everything. We feel happy when our babies eat. We like it when they finish their bottles (and we tend to prepare full ones, not half-full ones). And we encourage them to keep drinking until they do. Interestingly, another study showed that babies fed breast milk from bottles gained more weight than those fed from the breast. When we can see there is more there, we are more likely to push babies to finish the bottle—and in doing so, make feeding less about hunger and more about, well, finishing. The average 2-month-old doesn’t need 6 ounces or more at a feeding, but will often take it if pushed to do so. A study published earlier this year in the journal Pediatrics suggests that this super-sizing of servings and waistlines can start really early. Researchers surveyed the families of almost 400 2-month-olds that were only fed formula. They found that about half of them used bottles that were less than 6 ounces to feed their babies, and half used bottles that were 6 ounces or more. When they checked in with those babies at 6 months, the babies who were fed from bigger bottles had gained more weight than those who were fed from the smaller bottles—and were overall a bit chubbier (their “weight-for-length” was higher). The problem is that overweight babies are more likely to grow into overweight children, who are more likely to grow into overweight adults. What our minds and bodies learn early about eating can stick for a lifetime. I am not saying that everyone should start feeding their baby less. But I am saying that we need to be more mindful and aware of how, and how much, we feed our children. A 2013 study showed that when children were given kidsized plates as opposed to adult-sized plates they served themselves less food and gained less weight, and this is the same idea. It’s all about giving babies (and children, and adults) the amount of food they actually need—and making sure they know when they are full, and know to stop when they are full. If parents aren’t sure how much their child should be eating, they should check with their doctor. And they should remember that not all cries mean hunger; sometimes babies are tired, need a diaper change or just want to be held. Let’s not let super-sizing start with babies.
—By Claire McCarthy, MD, Faculty Editor, Harvard Health Publications Follow her at @drClaire Source: http://www.health.harvard.edu/blog/can-super-sizing-start-baby-bottles-201606219919 24
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If you consider the family dog family — and are apt to toss him a piece of your food now and then—proceed with caution. Some foods meant for human consumption can be dangerous, and even deadly, to your dog. According to Carmela Stamper, D.V.M., a veterinarian at the U.S. Food and Drug Administration (FDA), an animal’s body processes food much differently. “Our bodies may break down foods or other chemicals that a dog’s can’t tolerate,” she says. Allergies in animals tend to manifest themselves more in skin or ear issues. “Certain food might harm one dog and not another. It depends on a number of factors, including the animal’s genetic makeup and size, as well as the amount that animal eats. A big lab that eats a bar of dark chocolate may not have any problems, whereas a Chihuahua could get dangerously ill,” she explains.
Moldy foods can be dangerous to your pet. If you put moldy cheese rinds or hamburger buns in the trash can, make sure your dog doesn’t then get into the garbage. By the same token, if you have a compost heap and it’s the first place your dog makes a beeline for, be sure the moldy scraps are well out of reach.
Good Dog, Bad Food: Foods for People That Are Bad for Your Dog
Onions, garlic, and chives (as well as onion and garlic powder) can be harmful to your dog, in large amounts. If you’ve put a lot of onions and garlic powder in your salsa, marinade, or beans, don’t let your dog get into the leftovers.
Salty snacks, in large quantities, could also cause problems in your dog. “Feeding the odd potato chip or pretzel probably won’t do any harm,” Stamper says. But if your dog gets into a whole bag of them, he could get really sick. Make sure your dog has access to plenty of water at all times, especially if he gets into salty snacks.
What Foods Top the List?
More Ingredients Your Dog Should Avoid
Raw meat, which can contain E. coli, Salmonella, or other harmful bacteria. If you’re making hamburger patties or setting out steaks and chicken breasts, make sure they’re well out of reach of your counter-surfing canines; you’re not doing them any favors by tossing a chunk or two. Don’t handle raw meat and then give your dog a treat unless you’ve washed your hands first. And remember it works the other way around, too. “People can get sick after handling contaminated dog food, not washing their hands, and then using their hands to eat a sandwich or a slice of pizza,” Stamper says.
Macadamia nuts can be very harmful to dogs. If you’re packing white chocolate chip macadamia nut cookies, make sure they stay in the picnic basket and out of reach of your dog.And, while many dog owners know chocolate is bad for their dogs, but they may not realize that xylitol, a sugar substitute used in many sugarless products, can be deadly for him. Xylitol is found in sugarless gum, candies, oral products, and some peanut butters and other nut butters. If you feed your dog pills coated in peanut butter, or put peanut butter in their hollow chew toys, make sure to check the list of ingredients first to make sure it doesn’t contain xylitol.
Grapes, raisins, and currants can cause kidney failure in some dogs. Stamper says not all dogs are affected, but if you think you’re handing your dog a healthy snack, you could be disastrously wrong. But what about other fruits? For instance, can dogs eat apples and bananas? Stamper says yes—but never feed your dog the core or seeds. Fried and fatty foods can not only give your dog a stomach ache, but can also cause a potentially lifethreatening disease called pancreatitis. AUTUMN 2016
A Word about Cats Stamper says that cats are far pickier eaters than dogs and do not often get into trouble by eating foods that will harm them. However, cats are super-sensitive to onions, garlic, and onion and garlic powders, so make sure your cat has no opportunity to eat foods made with these ingredients. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm512230.htm
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Most people never think about gallstones—that is until they experience the severe, gut-piercing pain of a gallstone attack. These often strike after eating, especially a high-fat or high-cholesterol meal, and can last about 30 minutes to two or more hours. The attacks often begin in the upper-right side of the abdomen and may spread to the back, between the shoulder blades, and under the right shoulder. Nausea or vomiting may also occur. What you should not do is ignore these attacks, or try to just endure them, says ,” says Dr. William Brugge, past director of gastrointestinal endoscopy at Harvard-affiliated Massachusetts General Hospital. “Gallstone attacks are a warning sign that there could be potential serious complications in the gallbladder.”
Know your risk factors If you have avoided gallstones so far, do not think you are immune. Gallstones occur more in women ages 20 to 60. However, they equally strike both genders after age 60. Other factors raise your risk, too. For instance, overweight people are more susceptible since gallstone formation is associated with excess weight, which is often a result of consuming too many high-fat and high-calorie foods. Genes also play a factor. Anyone with a family history of gallstones is at a higher risk. There is no surefire way to prevent gallstones, but you can take certain steps to protect yourself. Diet and weight loss have the biggest impact, says Dr. Brugge. “Adopt a diet that cuts out high-fat foods in favor of more plant-based foods, as well as regular exercise to help you maintain a healthy weight,” he says.
Attack of the Gallstones
Yet, make sure to avoid rapid weight loss, which also can lead to stone formation, says Dr. Brugge. Aim to lose only about 1 to 2 pounds per week.
They affect more women, but men still are at risk
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How gallstones are made
Not always a problem
Gallstones form because there is too much cholesterol in your bile, a fluid made by your liver to digest fat. Bile is stored and released during digestion by your gallbladder, a pear-shaped organ under the liver.
Once gallstones form, however, they do not always need to be removed. “If they do not interfere with the function of the gallbladder and don’t cause symptoms, there is no need to remove them,” says Dr. Brugge.
This excess material forms crystals that then clump together to form stones. They vary in size from a grain of sand to a golf ball, but most are pebble-sized.
However, if severe problems do arise, the best option is to remove your gallbladder and thus the stones. Gallbladder surgery is one of the most commonly performed procedures. Patients often make a quick recovery and can return to normal life in a few days, says Dr. Brugge.
Gallstone attacks occur when they become too big or too abundant and block the normal flow of bile. “The pain is not from the stones themselves, but from spasms of the gallbladder as it tries to push bile through,” says Dr. Brugge.
Life without a gallbladder
If too much bile gets trapped, the gallbladder can become inflamed. “Bile also can back up and enter the blood, which can cause jaundice, a condition in which the skin and whites of the eyes appear yellowish,” says Dr. Brugge. Other symptoms may include sweating, chills, low-grade fever, or dark-yellow colored urine.
If your gallbladder is removed, you still can live a healthy life. The bile will instead flow directly from the liver to the small intestine rather than being stored. However, the bile becomes less concentrated, which makes diarrhea more common. You can manage this by eating a lower-fat diet, which causes less bile to be released, and increasing your fiber.
You need to seek immediate medical care if you have any of these symptoms or experience gallstone attacks that have become more frequent or severe.
Harvard Men’s Health Watch http://www.health.harvard.edu/diseases-and-conditions /attack-of-the-gallstones
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AUTUMN 2016
Pros and Cons to Detox Cleanse Diets Detox diet adherents tout the benefits of cleansing their bodies. The detox craze can be confusing, and misinformation regarding the best way to proceed with a cleanse only illustrates the emphasis men and women considering detox diets must place on learning as much about them as possible. Detoxing involves changing one’s diet for a predetermined period of time for the purpose of ridding the body of unhealthy, potentially toxic substances. While there may be some immediate weight loss associated with detoxing, losing weight is not the main purpose of detoxing. Detox diets tend to be restrictive diets, which may not make them practical for everyone—particularly those who may have health ailments or specific dietary needs. Consult with a physician prior to beginning a detox diet to ensure it will not interfere with any treatments. In addition, it can help to weigh the advantages and disadvantages of detox diets to determine if doing a cleanse is the right choice for you.
Pros
Eliminate poor eating habits: Cleanses may help you to take better inventory of your eating habits and encourage you to make healthy choices in the process. Detox diets require that their adherents eliminate particular foods for a period of time, and in many instances, these off-limits foods are overly processed items that may not be the best food choices in the first place.
Increase vitality and energy levels: Detox diets can sometimes increase one’s energy and stamina. This can translate into more motivation to exercise or be active. New foods: A detox may require you to increase consumption of whole foods and participate in “clean eating.” Eating cleanly is about selecting the healthiest options in each of the food groups. You may be exposed to new ingredients and discover healthy options you love. Benefit the immune system: You may find that healthy eating has positive effects on your immune AUTUMN 2016
system. This may make it easier to fend off illnesses or improve recovery time on those occasions when you get sick.
Cons
Potential for nutrient deficiency: Restrictive eating may deprive the body of certain nutrients it needs to remain in optimal shape. Nutrient deficiency can be dangerous, so it’s important to proceed with caution.
Weight loss concerns: If your goal is to lose weight, do not expect detox diets alone to produce permanent weight loss. Many people experience weight gain after they stop a detox, says the health resource Everyday Home Remedy. Weight loss is better achieved gradually and through consistent healthy eating and exercise than through a cleanse. Potential to overextend detox diets: Some people extend a detox for longer than is recommended in an effort to experience greater gains. They may feel that two or three weeks of a cleanse may be doing more good than simply one week. This is not a good idea because you can deprive your body of the balance of foods it needs to thrive. Detox diets can be short-term dietary options that bring about renewed vigor and health. Speak with a doctor and nutritionist to determine if a cleanse is best for you.
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A Grape Idea Grapes make the perfect snack: they are delicious, with a juicy burst of flavor, and are hydrating, easy to eat and portable, and offer a variety of nutritional benefits. Grapes are a natural source of beneficial plant compounds, including antioxidants and other polyphenols. At just 90 calories per serving, they also contain no fat, no cholesterol and virtually no sodium. This healthy, handy fruit is also a versatile ingredient, making grapes a perfect way to enhance your favorite foods and recipes. With their delicately sweet flavor and vibrant hues of red, green and black, grapes lend a delicious and attractive addition to dishes from breakfast to dinner. The recipes that follow highlight the art of the possible with fresh grapes.
Grilled Ginger Salmon and Grape Rice Bowl Servings: 4 4
2 1 1 2 2 2 4 2 1
boneless salmon fillets (3 ounces each), skin on kosher salt freshly ground black pepper tablespoons unseasoned rice vinegar tablespoon grated fresh ginger tablespoon honey teaspoons extra-virgin olive oil cups mixed green and red California grapes, halved scallions, thinly sliced diagonally cups hot cooked brown rice cups finely shredded green cabbage teaspoon sesame seeds reduced sodium soy sauce (optional)
Heat grill to high and oil grates. Sprinkle salmon with salt and pepper; set aside. In small saucepan, combine rice vinegar, ginger, honey and olive oil, and bring to simmer over high heat. Stir in grapes and scallions, and season with salt and pepper. Set aside off heat. Grill salmon, skin side up, 5-6 minutes. Turn and grill another 2-3 minutes, or until salmon reaches desired doneness. Divide rice among four bowls and top with cabbage and salmon. Spoon grape mixture over top and sprinkle with sesame seeds. Serve with soy sauce, if desired. Nutritional information per serving: 487 calories; 23 g protein; 69 g carbohydrates; 13 g fat (24% calories from fat); 3 g saturated fat (6% calories from saturated fat); 43 mg cholesterol; 301 mg sodium; 6 g fiber. 28
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AUTUMN 2016
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Hearty Quinoa Salad with Grapes and White Beans Servings: 12 Quinoa 2 cups (12 ounces) quinoa 2 cups vegetable stock 2 cups water Lemon 1/2 1/2 2 1 1 1/2 1 1/2 1 1/2
Pepper Dressing cup white wine vinegar cup lemon juice tablespoons olive oil clove garlic tablespoons honey teaspoons lemon peel, grated teaspoon salt teaspoon coarsely ground pepper
Salad 4 2 2 1 1/4 1/4 12
cups California grapes cups Chinese pea pods, cut in 1-inch pieces cups canned small white beans, drained cup diced celery cup minced cilantro cup Anaheim peppers, chopped lettuce leaves
Rinse and drain quinoa. In large saucepan, combine with broth and water. Bring to boil, reduce heat, cover and simmer 10-15 minutes. Drain any remaining liquid. To prepare dressing, combine vinegar, lemon juice, oil, garlic, honey, lemon peel, salt and pepper; mix well. Add 1/2 cup of dressing to quinoa; mix well and cool. Add grapes, pea pods, white beans, celery, cilantro and peppers to quinoa and mix well. Refrigerate until ready to serve. Serve on lettuce leaves. Nutritional information per serving: 219 calories; 8 g protein; 40 g carbohydrates; 4 g fat (18% calories from fat); 0 mg cholesterol; 363 mg sodium; 5 g fiber. —continued on the following page
AUTUMN 2016
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Fruit Breakfast Crepes Servings: 6 Crepes 1/2 cup low-fat milk 1 egg pinch of salt 3/8 cup (1.5 ounces) flour 1 tablespoon butter, melted Filling 1 1/2 cups California grapes, halved 1 1/2 cups oranges, peeled, sliced & quartered 1 tablespoon sugar 1/8 cup orange juice or orange flavor liqueur 1 teaspoon grated orange peel 6 tablespoons nonfat sour cream Cinnamon sugar 1 tablespoon granulated sugar 1/2 teaspoon cinnamon
In blender, combine milk, egg and salt; add flour and butter. Blend at high speed 1 minute. To make filling, combine grapes, oranges, sugar, liqueur or juice, and orange peel; set aside. Heat lightly-buttered 7-inch skillet or crepe pan over medium-high heat. Pour 3-4 tablespoons batter into pan; tilt to spread batter to cover bottom of pan. Cook over medium-high heat about 1 minute, or until batter is set. Turn crepe and cook about 30 seconds, or until lightly browned. Fill each crepe with 1/2 cup of filling; fold in half or roll up. Top with 1 tablespoon sour cream and sprinkle with cinnamon sugar mixture. Nutritional information per serving: 145 calories; 4 g protein; 26 g carbohydrates; 3 g fat (20% calories from fat); 1.7 g saturated fat (11% calories from saturated fat); 39 mg cholesterol; 80 mg sodium; 1.7 g fiber.
Roasted Squash and Grape Salad with Pesto Servings: 4 24 1 1
2 1 1/2 4 4 30
ounces cubed butternut squash (1 1/2-inch pieces) tablespoon extra-virgin olive oil tablespoon chopped fresh rosemary kosher salt freshly ground black pepper tablespoons reduced-fat prepared pesto cups halved red or green California grapes ounces bocconcini, drained and quartered cups arugula read caremagazine online at www.caremagazine.com
AUTUMN 2016
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Roasted Squash and Grape Salad with Pesto continued
Heat oven to 425 F. Place squash on sheet pan with sides and drizzle with oil, rosemary, salt and pepper. Mix well and roast until squash is browned and soft, about 25-30 minutes, turning after 15 minutes. In large bowl, combine warm squash with pesto; add grapes and cheese and gently toss. Season with salt and pepper, to taste. Divide arugula among four serving plates, top with squash mixture and serve. Nutritional information per serving: 264 calories; 8 g protein; 33 g carbohydrates; 13 g fat (44% calories from fat); 5 g saturated fat (17% calories from saturated fat); 25 mg cholesterol; 223 mg sodium; 5 g fiber.
Find more recipes for every meal of the day at grapesfromcalifornia.com. recipes courtesy of Family Features
Grape news! The eyes have it Recent research from the Bascom Palmer Eye Institute at the University of Miami, funded by the California Table Grape Commission, suggests that eating grapes may help contribute to eye health. The laboratory study showed that a grape-enriched diet preserved the retina’s structure and function against damaging oxidative stress.
Findings from two earlier laboratory studies at different universities also showed that grape consumption helped protect the retina from deterioration. AUTUMN 2016
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