Health & Wellness Journal Health
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wellness
Feb - Mar 2013
INSIDE
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medical
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research
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sports
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fitness
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Lifestyle
Inspire, Inform & Educate
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beauty
21 th Edition
Proud to Be a Health Care Professional
Teaching Kids About Successes And Failures - Confessions Of A Proud Dad By Stuart Adams The first few years of my son’s life were tougher than what they ought to have been. PAGE 12
If I’d Had To Wait Until 67 For Medicare, I’d Be Dead By Russ Mitchell A proposal to raise the Medicare eligibility age from 65 to 67 to ratchet down spending is one of the more explosive ideas in the fiscal talks PAGE 19
Sisters Network, the only national African American breast cancer survivorship organization in the United States, prepares to Walk For A Cure. Eat Potassium Rich Foods to Lower Blood Pressure By Richard M Harrison Potassium is one of four essential electrolytes (sodium, potassium, calcium and magnesium) used in the body. PAGE 21
New Coverage May Spur Younger Women To Use Long-Acting Contraceptives By Michelle Andrews Under the Affordable Care Act, new plans or those that lose their grandfathered status are required to provide a range of preventive benefits PAGE 25
Amerigroup, proudly serving Texas for over 15 years, is truly Heath Care that Cares.
Sterling Carter Stewart Cadillac Community Champion of the Month
“The groundwork of all happiness is health.” James Leigh Hunt (1784 – 1859) – an English critic, essayist, poet and writer
Feb - Mar 2013
Behind The
Journal
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Publisher’s Message
Keith J. Davis, Sr.
SR. PUBLISHER Keith J. Davis, Sr. VICE PRESIDENT Kevin Davis
Let’s get physical! March is the month where you decide if you are serious about working on that fit and fabulous physique. This month’s issue addresses not only that topic, but other topics that build a healthy community. Eat right, exercise, and taking care of you should be a priority if you plan on living long and prospering. So pull out those New Year’s resolutions, dust them off and make them a priority. You’ll be glad that you did.
EDITING CONSULTANT Sharon Jenkins OPERATIONS COORDINATOR Johnny Ray Davis, Jr.
As always again, thank you for your continued support of d-mars.com. When you support d-mars.com, you are supporting more than just our company; you are supporting the communities in which we live and work. Working together, we can succeed in making positive things happen. Happy reading!
ACCOUNTING MANAGER Eugenie Doualla
CONTENTS
SENIOR ACCOUNT EXECUTIVE C.T. Foster Eric D. Goodwine
Sisters Network, Walking for a Cure ............................................................................................... 4
PHOTOGRAPHY L.C. Poullard Grady Carter Tony Gaines
6 Tips to Make a Healthy Breakfast ................................................................................................ 7 If You Want to Sleep Better & Improve Your Brainpower, Try Music! ............................................... 9 When An Employer Drops Coverage, Workers Lose Their Tax Advantages ................................... 10
MULTIMEDIA DIRECTOR Andrea Hennekes
Teaching Kids About Successes And Failures - Confessions Of A Proud Dad .............................. 12
LAYOUT & GRAPHIC DESIGNER Ferland Antwine
Sports and Nutrition - Fueling Your Performance ........................................................................... 16
DISTRIBUTION Booker T. Davis, Jr. Rockie Hayden
A Little Imagination Can Boost Your Motivation Building a Better Body Image ............................. 17
CONTRIBUTING WRITERS Sharon C. Jenkins Stuart Adams Russ Mitchell Richard M Harrison Michelle Andrews Dean Anderson Jordan Rau Ryan Byers Maren Sederquist www.SixWise.com John MM
If I’d Had To Wait Until 67 For Medicare, I’d Be Dead .................................................................... 20
How to Choose a Fitness Boot Camp .............................................................................................
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Health Care That Cares! .................................................................................................................. 16 Nutrition and Teens: A Guide for Parents ....................................................................................... 18 Too Much Water? Or Too Little? ...................................................................................................... 18 Eat Potassium Rich Foods to Lower Blood Pressure ..................................................................... 22 Americans Uncomfortable Around Mentally Ill Despite Acknowledging Discrimination ................ 24 New Coverage May Spur Younger Women To Use Long-Acting Contraceptives ..........................
MR. D-MARS Tip of the Month “A vigorous five-mile walk will do more good for an unhappy but otherwise healthy adult than all the medicine and psychology in the world.” Paul Dudley White (1886 – 1973) An American Physician and Cardiologist
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Sisters Network, Walking for a Cure $50,000 was set aside to provide financial support to women facing financial challenges after breast cancer diagnosis. • I encourage you all to participate in our 4th Annual National 5K Walk/ Run on Saturday, April 13, 2013 at Discovery Green Park in Houston, Texas. Register your team at www. stopthesilencewalk.org
OV ERV IEW • Sisters Network is a Leading voice and the only national African American breast cancer survivorship organization in the United States. Founded in 1994 by Karen E. Jackson, Founder/CEO, a breast cancer survivor diagnosed in 1993 • Purpose is to save lives and provide a broader scope of knowledge that addresses the breast cancer survivorship crisis affecting African American women around the country • Why do we exist? That’s simple, just look at the recent statistics for African American women: • Breast cancer is the second most common cause of cancer death among African American women, surpassed only by lung cancer • An estimated 26,840 new cases of breast cancer are expected to occur among African American women in 2012 • Finally, the five year survival rate for African American women was 78%, compared to 90% among whites. • Sisters Network is getting the message directly in our communities that we must Stop the Silence® about breast cancer in the black community, so our women can start beating the odds. • 2012, Sisters’ breast health outreach initiatives impacted an estimated 3.7 million families. • Currently, Sisters’ has over 40 affiliate survivor run chapters nationwide and is continuing to develop new chapters to support our national outreach efforts Local Statistics (Harris County : Harris County Public Health) • African American mortality rate in Harris County – 37.2 per 100,000; • For every 100,000 breast cancer deaths, 37 will occur in African American women from Harris County. • African American mortality rate in all of Texas – 35 per 100,000
• African American mortality rate in the US – 33 per 100,000 Breast Cancer Men (National; American Cancer Society) • About 2,240 new cases of invasive breast cancer will be diagnosed among men • About 410 men will die from breast cancer • Breast cancer is about 100 times less common among men than among women. • For men, the lifetime risk of getting breast cancer is about 1 in 1,000. • The number of breast cancer cases in men relative to the population has been fairly stable over the last 30 years. • The prognosis (outlook) for men with breast cancer was once thought to be worse than that for women, but recent studies have not found this to be true. • Men and women with the same stage of breast cancer have a fairly similar outlook for survival.
PROGR AMS AND EVENTS • BCAP –Breast Cancer Assistance Program provides services to women facing financial challenges. As a Survivor, this program provides financial assistance for but not limited to: medical related lodging, co-pay, office visits and prosthesis. This program also provides free mammograms. • 5K WALK/RUN In April, 2010 Sisters Network Inc. made history again by hosting the 1st National African American Breast Cancer 5K Walk /Run in Houston, Texas. Our 3rd Annual 5k WALK/RUN The Stop the Silence® 5K Walk/Run attracted over 6,500 participants from the greater Houston community as well as participants from cities across the United States. a. Funds raised from Stop the Silence® will benefit Sisters Network® Inc. Breast Cancer Assistance Program (BCAP);
PINK RIBBON AWAR ENESS INITIATIVE is Sisters’ national faith-
placed educational outreach program that reaches women in church with information on how to access breast care services and resources. • The goal is to increase the number of women obtaining mammograms and heighten their general knowledge of breast cancer awareness and Sisters Network® Inc. • Affiliate chapter members and community volunteers disseminate information on breast • cancer to African American churches across the United States. • SNI members give testimonies as survivor role models to encourage and inspire.
GIFT FOR LIFE BLOCK WALK®
is a nationally recognized educational outreach • Affiliate chapters of Sisters Network Inc. collaborate with organizations, community groups, and volunteers to coordinate the promotion of breast health awareness in the African American community. • This unique and innovative program allows a breast cancer survivor to partner with volunteers and canvass door-to-door in the African American community to distribute
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breast health education brochures and resource information. • Free Mammography screenings are also offered by a mobile unit at select event sites.
10 C I T Y N A T I O N A L CONFER ENCE TOUR • In 1999, the organization made history by hosting the first and only National African American Breast Cancer Conference. The 2013 conference tour is an extension of the national conference and will highlight triple negative and advanced breast cancer. • Now in its 14th year, the Conference Tour will attract more than 1000 participants, including nationally recognized medical experts.
HOW CAN YOU SUPPORT US? • BECOME A MEMBER-NonSurvivors are Associate Members and there is a membership fee $100 as a National Associate Member • As an Associate member, we ask that you represent SNI in your community to: 1. Distribute out SNI material 2. Public speaker using our scripted “talking points” 3. Inform national of resources in local communities I encourage you all to participate in our 4th Annual National 5K Walk/Run on Saturday, April 13, 2013 at Discovery Green Park in Houston, Texas. Register your team at www.stopthesilencewalk.org VOLUNTEER-CALL OR EMAIL US infonet@sistersnetworkinc.org /866-7811808 If you would like more information about Sisters Network, please visit www. sistersnetworkinc.org
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6 Tips to Make a Healthy Breakfast
M By John MM
any health magazines often state that breakfast is the most important meal of the day because it gets your metabolism going faster from early on, and it gives you energy throughout the day. But some breakfasts are not as healthy as you might think. We’ve put together 6 top tips to ensure your breakfast is a healthy start to the day. More healthy snack ideas can be downloaded from:
1. Stick to Whole Grain Foods If appropriate, stick to whole grains and foods that are low on the glycemic index. These foods contain energy in a form that has to be processed by your body before you can access it. As a result, the body can regulate the release of energy to make it last all morning, and not have you feeling hungry. Foods that are low on the glycemic index include whole grains, whole wheat bread, grapefruits and apples. High glycemic index foods include sugary cereals, watermelon and grapes.
2. Watch Out for Granola Watch out for granola cereals! Those wholesome looking granola type cereals can be packed full of bad trans and saturated fats, so watch out! They are often packaged to look very healthy but rarely are. Instead try to opt for a lower sugar and lower fat cereal.
3. Eggs Try eggs. Eggs don’t take much preparation like some breakfasts, and on paper they look like they’re high in fat. However we have evolved to eat eggs for many thousands of years and our bodies are efficient in breaking them down. This means that we can absorb a lot of energy and be more satisfied from having eggs for breakfast.
4. Avoid Fried Foods Avoid fried foods. Fried breakfasts, including fried eggs, bacon and fried toast are often fried in bad oils. You can switch to poached eggs instead of fried and grill bacon instead. This will substantially reduce your fat intake. If you have to fry it, try using olive oil which contains less of the bad fats.
5. Fish Opt for fish instead of meat. Meat can often contain a lot of saturated fat which can increase cholesterol. Processed meats such as salamis or sausages are worst, followed by fatty red meats. Fish is an excellent source of omegas 3 and 6. These are essential oils that our bodies need, but we don’t produce ourselves. Perhaps add smoked salmon to a wholegrain bagel or scrambled egg.
6. Coffee or Tea Drink coffee or green tea. Coffee gets a bad press, but a recent and large study suggested that people who drink coffee live longer. Of course it’s difficult to conclude that it’s all down to coffee, it might be that coffee drinkers are also more relaxed types of people for example! Green tea is another healthy breakfast gem. Green tea contains EGCG which is thought to assist the body in using fat supplies for energy rather than wasting muscle. This has led to the theory that drinking green tea can boost your metabolism. But that’s not all; EGCG has been scientifically linked to many health benefits.
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If You Want to Sleep Better & Improve Your Brainpower, Try Music! By www.SixWise.com
E
ver find that playing your favorite CD after a hard day, or listening to your favorite radio station before you go to bed, is soothing or actually helps put you in a better mood? There’s a reason why many people are inherently drawn to music, and that’s because music is far more than just noise in the background--it can actually help you to sleep better, improve your brainpower, reduce stress and more. And this news couldn’t have come at a better time, as a poll by the National Sleep Foundation found that three-quarters of American adults report problems with sleep. And as anyone who’s ever had a restless night’s sleep knows, not getting enough sleep can wreak havoc on your ability to function the next day. Said Richard Gelula, the National Sleep Foundation’s CEO, “People who sleep well, in general, are happier and healthier ... But when sleep is poor or inadequate, people feel tired or fatigued, their social and intimate relationships suffer, work productivity is negatively affected, and they make our roads more dangerous by driving while sleepy and less alert.” Fortunately, another study, published in
the February 2005 edition of The Journal of Advanced Nursing, found that older adults with sleep problems who listened to soft music at bedtime reported a 35 percent improvement in their sleep. The participants slept longer and better, and had less daytime dysfunction, after listening to 45 minutes of music before bed. “The difference between the music group and the control group was clinically significant,” said Hui-Ling Lai, lead author of the study. “The music group reported a 26 percent overall improvement in the first week and this figure continued to rise as they mastered the technique of relaxing to the sedative music.” Music, Your Brain, and Your Mood Music is not only good for sleeping, it’s also good for your brain, according to a study published last year in the journal Heart & Lung. Researchers found that people who listened to music while they exercised performed more than twice as well on a verbal fluency test than people who listened to no music. The test was designed to challenge the part of the brain that deals with planning and abstract thought. Said the study’s lead author, Charles
Emery, “ ... Listening to music may influence cognitive function through different pathways in the brain. The combination of music and exercise may stimulate and increase cognitive arousal while helping to organize cognitive output.” Further, music can have an amazing impact on many aspects of our health, including our mood, stress level and even ability to tolerate pain. There’s even a growing area of study called music therapy, in which music therapists work in medical and mental hospitals, day care centers, senior centers and more to help people with health problems ranging from Alzheimer’s disease to acute and chronic pain. According to the American Music Therapy Association, music can be used to: • Reduce stress (either by making music, such as drumming, or listening to music passively for relaxation) • Provide support for exercise • Assist a woman with labor and delivery • Alleviate pain in conjunction with anesthesia or pain medication • Elevate mood and counteract depression
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• Promote movement for physical rehabilitation • Calm or sedate a person to induce sleep • Relieve fear or apprehension • Lesson muscle tension As Americans are constantly on the go, whether at work, with the kids or even during our “off time,” one of the most popular uses for music is simple relaxation. If you’re looking for a perfect CD to relax to, we recommend the Pure Relaxation CD. It uses guided mediations and music that will calm your mind, soothe your emotions and create a state of deep relaxation in your body. It’s just the thing to calm your nerves after a tough day. Aside from music, if you’re looking for some other keys to relaxation (and who isn’t?), check out our past article, How to Relax (and Lower Your Cortisol Levels): A Golden Key to Your Health. American Music Therapy Association Health Orbit April 22, 2004 ABC News EurekAlert
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When An Employer Drops Coverage, Workers Lose Their Tax Advantages By Aichelle Andrews
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ith just a year to go before the most significant changes under the Affordable Care Act take effect, readers have many questions about how the law will affect them. Q. My employer, with over 3,000 employees, is holding meetings with us explaining the health-care law and how expensive it is going to be for us and for them. My employer is saying it will likely drop our insurance and make us buy our own. Will the insurance premiums still be a pre-tax payment? Are there affordable options for me and my family? A. If your employer drops your health insurance coverage and you have to buy your own plan, you would no longer be able to pay your premium with pretax dollars. That tax “exclusion” -- your health insurance benefits are excluded from taxable income -- cost the federal government an estimated $240 billion in 2010, according to an analysis by the Urban Institute. Politicians on both sides of the aisle have suggested eliminating it, but Congress has not taken action on this. Starting in 2014, if your employer stops offering coverage, you can look for a plan on the health insurance exchanges that will be functioning in every state. Even though you wouldn’t get the tax break you
currently receive, there will be subsidies available to people with incomes up to 400 percent of the federal poverty level ($92,200 for a family of four in 2012) to help make coverage more affordable. Although employers may consider dropping health insurance coverage, they could face financial penalties for doing so. Under the health-care law, companies with more than 50 employees will be fined $2,000 per employee if they don’t offer health insurance and any of their employees receive tax subsidies when seeking insurance through the state-based insurance marketplaces, called exchanges, being set up by the law. (The first 30 employees are excluded from the penalty.) Q. What does the new health-care law mean for people like me, who use alternative medicine? A. The law spells out 10 categories of “essential health benefits” that most individual and small-group plans must cover starting in 2014, whether they are sold on a state-based health insurance exchange or on the private market. They include hospitalization, emergency care, maternity and newborn care and prescription drugs. Each state will pick an existing plan whose benefits include at least those 10 categories to serve as a benchmark for coverage. In general, other individual and
small-group plans will have to include the benefits covered by the benchmark plan. (Experts expect that the plan selections will be finalized in all states early this year.) If that state benchmark plans covers acupuncture, say, or chiropractic treatments, such services may generally be covered by other individual and small group plans in the state. But some policy experts say the latest federal guidance doesn’t make it clear that a benchmark plan’s benefits that don’t easily fit into one of the 10 essential health benefit categories of care, such as acupuncture, must be covered by all plans. Moreover, insurers are permitted in some instances to substitute benefits, as long as they are determined to be substantially the same in value under the law. So in theory, an insurer might decide to swap out acupuncture in favor of something else, such as physical therapy, says Karen Pollitz, a senior fellow at the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.) These essential health benefit rules don’t apply to large group plans, plans that pay employee claims directly and those that are grandfathered under the law. Coverage in those types of plans wouldn’t be affected. Q. My 21-year-old is on our health
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plan but has moved out of state. We were recently told by our health plan that he will not be eligible for coverage if he lives out of the area. Is this true? I thought children could now remain on their parents’ health plan up to the age of 26, regardless of where they live. A. You’re right. Under the Affordable Care Act, your son can stay on your health plan until he turns 26 even if he lives out of state. As a practical matter, though, you may find that if he needs care outside your plan’s service area, he may have to see an out-of-network provider, and that can get expensive. Some young people solve the problem by waiting to see the doctor until they come home to visit Mom and Dad. But for adult children with a chronic medical condition, that may not be possible. Your son will have access to “whatever the plan is required to cover in terms of emergency care or out-of-network care,” says Jen Mishory, deputy director of Young Invincibles, an advocacy organization for young adults, but “the insurer doesn’t have to have a national network of providers.” Please send comments or ideas for future topics for the Insuring Your Health column to questions@kaiserhealthnews.org. We want to hear from you: Contact Kaiser Health News
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Teaching Kids About
Successes And Failures Confessions of a Proud Dad By Stuart Adams
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he first few years of my son’s life were tougher than what they ought to have been. By the age of 5, this was a very scared young boy with no self-confidence and a poor self-esteem. Up to that point it was far easier for me to ignore this, as to acknowledge it also meant acknowledging the painful reality of my contribution towards my little boy’s fears. The other difficult part was having absolutely no idea how to turn the situation around. Since then, I’ve made turning the situation around to be my number one priority, and as such have seen miraculous changes. The foremost strategy I have been using is simply to take control of some of the experiences he has where he’s facing a challenging situation, so as to ease him into it at a rate I know he can succeed at. After each achievement, his progress is then reinforced by bringing each achievement to his awareness. “When you started you were too scared to let go of my hand, yet look at how far you just swam on your own!” I’d remind him excitedly each week since he started swimming lessons this year. “Only a few months back you could barely read ‘dog’ and ‘cat’ - now you can read almost all the street signs! Look at how good you are now because of all the practice you’ve been doing!” I’d celebrate with him each day on the way to school. On each occasion, to start with he was reluctant to acknowledge his achievements, almost as if the empowering feeling it would bring him was fearfully unfamiliar. It would usually take a few minutes to sink in, before his demeanor gradually changed as his confidence slowly rose to the surface. I even made a habit of taking photos of all the activities he had been making progress in as well, printing them out as small posters captioned by “I’m good at…” or “I like…” followed by the activity he was doing in the photo. Those photos are on every wall of the house now; so that he can see them every single day (they also give him something to practice reading). With his first year at school over and his second just commencing, my now 6 year old son is much more aware of what he is good at and understands what it means to be confident. Running, long jump, swimming, spelling, reading, writing, math, drawing, painting, music, making friends, showing manners - these are just some of the skills my little man can now list as things he is confidently ‘good’ at. Learning to achieve and accept success is something that has taken a lot of work with my son, though in the process, it recently dawned on me that knowing how to accept failure and defeat was, despite being the most important part of success, something he had yet to understand. I have noticed
him get a bit teary eyed on occasion at Little Athletics when he failed to come a place, but just how much he has become unable to deal with being beaten became apparent to me only yesterday. I’ll describe to you what happened and how I decided to deal with it; on the condition that you tell me your thoughts and how you think I can do so better in future. A few weeks ago, his Grandpa taught him how to play chess, and he has been playing whoever he can, whenever he can, ever since. In my well intentioned efforts to give him confidence, whenever I play him at anything, I usually let him win, but only just barely win, so that he pushes himself to explore new levels of understanding about his abilities. Yesterday, I forgot to let him beat me. “But…but…I can still move here” he kept insisting desperately, no matter how many times or with how much compassion I persisted in assuring him that it’s okay to let someone else win sometimes. His inability to accept defeat continued. The tension appeared to be mounting in him like an ever-inflating balloon, which, after at least 5 minutes of persistence, finally popped. The outburst not only resulted in tears being shed, but an uncontrollable shaking, reminiscent of a panic attack. Whilst I did try to calm him, it was difficult to stay calm myself, as I realized that this inability to show weakness had come from me. So, as he cried uncontrollably, I figured what the hell - so I did too. There we were; father and son, both crying together, and over a chess game? No, it was much more. It was about accepting that to have control, sometimes you have to allow yourself to lose control. Even instinctively, as I write this, it feels almost unnatural and anti-masculine to admit sitting alone in my lounge room, holding my 6 year old son whilst we both cried together. It feels like an offence on my pride. But that however, I realize now, is precisely the problem. Letting male pride stand in the way of being able to show the emotion of defeat, the humility of letting go and the fear of losing control, has done what good exactly? If hanging onto that pride caused my son to have a nervous breakdown over a bloody chess game, how the hell will it affect him in other aspects of life? I was eventually able to calm him by talking about more pleasant memories. We did other things for a while, but eventually he summoned up the courage to play another game of chess, once he was reminded of how brave he was of course. Once again, I beat him. This time I did it on purpose. I knew the risks, but I had to take it. This time I was prepared for the reaction, and had the opportunity to
intervene and guide his mind in a much more positive direction. In order to free him of the powerfully negative emotional attachment he had developed with the experience of losing, I joked around with him, working him up into a state of laughter, and even got him to say out loud that “I lost and it feels okay”. Eventually he was even able to manage “I lost and it feels good” to be said with a smile and a laugh, followed by a great big hug. “This time” I explained, “we’re going to play again. Only this time I’m going to tell you over and over again, that you’re going to lose, that you should give up and that there’s no point in trying.” This I did, continuously over and over throughout the game. When I could see it was starting to get to him, I changed the tone of the taunting to sound playful, or worked up the intensity just as I let him take one of my powerful pieces, thus severing the emotional severity of the taunts. Despite the taunts, he persisted, and eventually, he won. I’m not sure how much of the explanation about needing to accept failure to appreciate success he really understood. I’m not sure that he understood then the importance of ignoring the voice that comes in the face of failure that tries to get us to give up, or the enhanced accomplishment that comes from pushing past that voice (though hopefully that understanding will come later). I think the part he understood most however was that no matter what situation he’s up against or who else he is competing
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against, the only opponent he ever has to worry about is the monster that lies within each of us, that brought about that dreadful hurt he felt whilst gushing tears and shaking uncontrollably. I’m pretty sure that whilst he doesn’t quite understand what that monster is, he knows now that he can beat it, because he has beaten it, and felt good after having beaten it so that now, the idea of winning takes on a new context. He’s been exuding a new essence of confidence since that moment, so I hope I did the right thing, and that it had the right effect. The most important lesson I took away from this experience is that in addition to showing my son how proud I am of him when he succeeds, I need to balance that by showing how proud I am of him when he accepts defeat. To do that I must not only show how proud I am that he can overcome his fears, but allow him to feel free to express those fears. I guess the hardest part of all is that now I know, in order for him to feel free to express his fears; he must first see that I can do the same. It appears I have much work do to. This is my start. About the Author About the Author: Stuart Adams is a Teacher, Careers Advisor, Dietitian and the Founder of Top of the Class Professional Tuition. For more articles on parenting, teaching and coaching kids for success, see the Home Tutors Sydney website.
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How to Choose a Fitness Boot Camp
By Ryan Byers
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our body and its state of physical fitness are your most important assets. You should always remember that it is always easier to keep healthy, then to regain your health. Of course, it can also be cheaper to stay healthy then to get treated medically. Thus, it is imperative for everyone to take steps to keep their bodies physically fit and in shape. However, fitness is a diverse concept. In order to be considered as fit, you have to reduce your weight to its normal levels, you have to increase your cardiovascular endurance, you have to increase your strength and you have to undergo resistance training. However, all of this can be very difficult to do, especially if you don’t know how to proceed. In the beginning, many people try to achieve fitness on their own with the information that they learn from the media and the Internet. But, mostly this can be a futile effort as achieving fitness requires effort, motivation and finesse in order for you to succeed. You can’t hope to combine the proper exercises in their proper intensity levels. Thus, you would need something like a personal fitness instructor to help you along the way. Of course, hiring a personal fitness instructor can be an expensive method, since you would have to pay at least $100 to $150 per hour to keep a fitness instructor. You can easily see that the bills can pile up very quickly. However, you don’t need to worry as you have another viable alternative. This viable alternative is to go enroll in a fitness boot camp. A fitness boot camp is a special fitness camp with several fitness instructors who channel your efforts to create the best possible fitness for yourself. In a boot camp, you will be able to have many benefits for attaining fitness such as: 1. Working in a group environment to attain fitness 2. Getting help from your fitness instructors on difficult fitness techniques 3. Getting motivated from your group members and from your instructors 4. Being able to do group fitness activities 5. Your meals are kept under control in a fitness boot camp 6. Your sleep and your rest periods are
also regulated for best results 7. Your fitness achievements (such as your weight, your cardiovascular endurance, your resistance strength etc) are continuously measured in order to track your progress. 8. Whenever you don’t feel up to it, a fitness boot camp can make sure that you continue your fitness program without giving up 9. A fitness boot camp can be much more cheaper than hiring a personal fitness instructor, as you can continue with only $100 to $350 per month on most fitness boot camps 10. You can make sure that you always have the help you need in a group setting. So, as you can see, a fitness boot camp can be the perfect solution for your weight loss as well as your fitness needs. So, then you may ask yourself on how to find the best fitness boot camp for yourself. Well, the best way is to make sure that you look on the Internet to find the best fitness boot camps in your area. Then you can easily talk to them and examine the various programs that they offer. Or another way on how to find the best fitness boot camp can be to ask around to your friends and neighbors on the fitness camps that they may have used. Make sure that you go and visit the relevant fitness boot camp before you enroll. You have to be certain that their program and their instructors are compatible with your needs. However, don’t make the mistake of going to a fitness boot camp that doesn’t really force you to attain your best. You will need some gentle pushing and encouragement in order to make sure that you get your level of fitness that you desire. Don’t forget that achieving fitness and weight loss requires patience and diligence for you to be successful and this can be best achieved in a fitness boot camp. About the Author Ryan, a former collegiate baseball player at Armstrong Atlantic State University and Southern Polytechnic State University, Ryan, a fitness boot camp instructor at Step It Up Fitness boot camp in Atlanta, GA.
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Sports and Nutrition -
Health Care That Cares!
Nutrition - The Right Balance
By Sharon C. Jenkins
Fueling Your Performance By Dean Anderson, Behavioral Psychology Expert
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ust as a car runs best with a full tank of gas, your body needs the right kind of “nutritional fuel” for peak performance. Eating well for your sport can be very simple. You do not need special foods or supplements. It is important to fuel your body with a balance of carbohydrates, proteins, fats, minerals, vitamins, and water. Carbohydrates or “carbs” (found in pasta, bread, cereal, rice, potatoes, fruits, milk, yogurt, etc.) are especially important for athletes because they supply the body with glucose (blood sugar) for energy. Extra glucose is stored in the muscles and liver as glycogen, your energy reserve. During short bursts of exercise such as sprinting, basketball, gymnastics, or soccer, your body primarily uses glycogen for energy. If you don’t have enough glycogen you can feel very tired, which will affect your athletic performance. During longer exercise, your body uses the glycogen stores first and then uses fats stored in your body to fuel performance. Fat is an important source of energy used to fuel longer exercise and endurance activities, such as hiking, cycling, and long-distance running. Eating a diet that is too low in dietary fat may decrease athletic performance and cause other health problems. Protein is needed for your body to build and repair muscles. Small amounts of protein may also be used for energy. Vitamins and minerals are not sources of energy, but they have many important functions in the body. For example, vitamin D and calcium are needed for strong bones, and iron is needed for blood cells to carry oxygen throughout your body. Certain minerals, like potassium, calcium, and sodium are called electrolytes. They are important during exercise because they affect the amount of water in your body and muscle activity. Athletes should eat a balanced diet with a variety of foods to make sure they get enough vitamins and minerals. It is fine to take a regular multivitamin, but supplements with high doses of vitamins and minerals do not improve performance and may actually be harmful. Water is essential to keep you hydrated (when your body has enough fluids). Dehydration (when you don’t have enough fluids) can cause muscle cramps and keep you from performing your best. Healthy Eating Tips for Athletes • Eat a variety of foods. Because different foods have different nutrients, you should eat a variety of foods to get all the nutrients you need to stay in peak condition. For example, oranges provide vitamin C and carbohydrates, but not iron or protein. A steak provides
iron and protein, but not vitamin C or carbohydrates. • Eat regular meals and snacks. Skipping meals will weaken your performance. Eating regular meals and healthy snacks is the best way to fuel your body for athletic events. • Eat enough calories. Calories fuel your body for exercise and replace energy that is used up during competition. Cutting calories keeps you from performing your best. Exercise and athletic training demands extra energy, and it is essential to meet your body’s energy needs if you want to compete at full strength. • Drink plenty of fluids. Athletes need more fluids than non-athletes. Do not wait until you are thirsty to start drinking water, because thirst means that you are already dehydrated. Remember to drink even more in hot and humid weather. What fluids should I drink and how much do I need? Before exercise: The goal of drinking fluids before exercise is to be well hydrated before you are physically active. If you have rested for at least 8-12 hours before activity and eat and drink regularly, extra hydration may not be needed. If you have lost fluids from sweating prior to exercise, have not been regularly drinking, or have dark, concentrated urine, then you may need 1-2 cups four hours before you begin exercising and another ½ - 1 cup two hours before. During exercise: Fluid needs during exercise depend on how intense and long your workout is, weather conditions, and how much you sweat. If you are going to be exercising for more than one hour, then it is recommended that you drink 2-4 cups of water per hour. If you are not exercising for more than one hour, then replace fluids according to your thirst and the weather (more fluid is needed in hotter, more humid climates). Sports drinks, such as Gatorade® or Powerade®help replace water, carbs, and electrolytes. Avoid sodas and drinks that contain caffeine, because they can actually dehydrate you. After exercise: After exercise, drink 16 ounces (2 cups) and return to normal eating and drinking patterns. Calorie containing drinks (like juice or a sports drink) can replace water and glucose. You can figure out if you are well hydrated by looking at the color of your urine. A clear color is a sign of good hydration. However, if you see a darker yellow color, this means that you need to drink more fluids. What should I eat to fuel my exercise? Fueling - Before Exercise: The food you eat before you exercise greatly affects the quality of your athletic performance. These tips will help you plan your pre-exercise meals to prevent
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merigroup has been proudly serving Texas for over 15 years. They provide STAR, CHIP, STAR+PLUS, and Medicare programs in counties throughout Texas. Amerigroup helps mothers, children, the elderly, and people with disabilities with their physical, behavioral, and social needs. And they help manage their members’ services in the community. Amerigroup works hard to improve the quality of health care for their members by participating in events that promote healthy living. Recently Amerigroup was proud to
participate in the NBA All Star Youth Clinic which aimed to promote physical activity in youth by teaching them basketball skills. NBA All Stars were onsite serving as the coaches making this a weekend that the youth would not forget. In addition, Amerigroup participated in Lunar New Year Festival events throughout the city of Houston which provided free screenings, education sessions and health information. Amerigroup currently serves more than 2.2 million people enrolled in Medicare, Medicaid, CHIP, and other programs designed to help families nationwide.
low blood sugar, to keep you from feeling hungry, and to fuel your muscles for training and competition. • Eat a larger meal if you have 3-6 hours before you begin your exercise. Smaller “mini” meals are better if have 2-3 hours before your workout begins. Meals that are high in complex carbohydrates (foods rich in carbohydrates that have long lasting energy power) are best because they fuel your muscles. Pasta, bagels, baked potatoes, rice, and fresh fruit are all good sources of complex carbohydrates. • Avoid high-bulk (high-fiber) foods such as broccoli, baked beans, or bran cereal right before exercise. These foods may cause stomach pains during exercise. High-fiber foods are loaded with good nutrition though, so be sure to include them at other times of the day. • Avoid sugars and sweets, especially soda and candy, less than 1 hour before training. High-sugar foods will give you quick energy, but won’t last long enough. • Limit foods that are high in dietary fat such as fast food, eggs, meat, and cheese that you eat for your pre-exercise meal. These foods take much longer to digest and may make you feel sluggish and tired if you eat too much of them. • Do not try new foods before a competition. You may have trouble digesting a food you have never eaten before. Choose foods that are familiar to you. Hours Before Exercise What to Eat What to Drink 1-2 Fresh fruits or vegetables (low fiber) Crackers, granola or cereal bars Water, fruit or vegetable juice 2-3 Granola bar & yogurt, ½ bagel & peanut butter, cereal & milk Water, fruit or vegetable juice 3-6 Fruits, vegetables, breads, bagels, peanut butter, lean meat, cheese, yogurt, full sandwich, cereal with milk & fruit, baked potato Water, fruit or vegetable juice Fueling - After Exercise: It is very important to refuel your body after a hard workout. Because your body replaces glycogen stores in your muscle within the first few hours after exercise, it is important to eat carbohydrates and some
protein soon after your workout. Follow these tips when planning your post (after)exercise meal. • Even if you aren’t hungry, you should eat a snack that contains carbohydrates within 30 minutes after your workout (such as a yogurt or half a sandwich). This will help your body recover quickly. • You should eat a larger meal that is high in carbohydrates and has some protein within the next 2 hours to replace your muscle glycogen stores that were used up during exercise. What is carbohydrate loading? Carbohydrate loading is a technique used to increase the amount of glycogen in muscles. It involves eating extra carbohydrates during the week before a competition, while at the same time cutting back on your training. Carbohydrate loading is intended for marathon runners and other elite athletes. Should I eat extra protein or use protein supplements? Although some extra protein is needed to build muscle, most people get plenty of protein from food. Getting extra protein from supplements will not have any added benefit. Eating enough calories is actually more important for building muscle. Without enough calories, your body can’t build new muscle. Should I eat energy bars? It depends. There are many different energy bars you can buy. Some are high in carbohydrates and others are high in protein. They do not contain any magic ingredients that will help your athletic performance. Regular foods that have some carbohydrate and protein in them like yogurt, cheese and crackers, or cereal bars are just as good and usually cost less. However, energy bars are convenient and may taste good. Energy bars are usually pretty dense and low in moisture, so make sure you drink plenty of fluids when you eat them. Remember: Athletes need more food and fluids than non-athletes. Regular meals and healthy snacks will help fuel your body before and after exercise. It is important to give your body enough of the right fuel in order to feel good and have the energy you need to be the best athlete you can be.
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Feb - Mar 2013
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A Little Imagination Can Boost Your
Motivation Building a Better Body Image By Dean Anderson, Behavioral Psychology Expert
“I really want to lose weight. I hate the way I look and feel, and I know things will be much better when I get the weight off. But I just can’t stay motivated to do it. I think there must be something wrong with me.”
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f this sounds like something you say to yourself, I’ve got good news for you. There probably isn’t anything seriously wrong with you. You have a very common problem that affects many people who want to lose weight—expecting your negative feelings about your body to do something they can’t do. The motivation you need to successfully lose weight is like a fire. It will burn hot and long when you provide it with the fuel it needs, but it will die out quickly if you don’t. Disliking how you look and feel might provide decent kindling to get the weight-loss fire started, but it’s not the proper fuel source to keep it going. When you’re driven by negative thoughts about yourself, you just don’t have the raw materials that are necessary to achieve the results you want. This problem lies in how our minds work. If I were to tell you, for example, that I’ll give you $1,000 if you can manage to not let the thought of “chocolate” enter your mind during the next 60 seconds, do you think my bank balance would be in big trouble? I don’t. It’s certain that some of your next few thoughts would have something to do with chocolate. Most likely, you’ll wonder how you can stop yourself from thinking about chocolate for 60 seconds—oops, too late! You lose, and my $1000 stays safely in my bank account. It’s virtually impossible to not think about something for a minute, when that’s what you set out to do. Try it for yourself. The same thing happens when you set out to lose weight because you don’t like your body. The first thing you’re likely to do every morning is notice how fat you still are, think about the food you can’t eat, or lie in bed, wishing you didn’t have to get up early to exercise. You might as well throw a big bucket of ice water on that motivational fire of yours, because sooner or later, you’re going to get very weary of this constant struggle and give up. So, what’s the alternative? What do you do if the reason you want to lose weight is because you don’t like the way you look or feel? Where do you find the right fuel for your motivational fire? Use your imagination. Imagination: More Important than Will Power
One thing that it’s crucial to understand is that being overweight isn’t the cause of your unhappiness, and simply weighing less won’t make you feel better about yourself and your life. It’s all the things you think about your body that make you unhappy, and it’s changing those thoughts that will make you feel better and help you lose weight. Think about it. Imagine you live in a society where people find thinness repulsive and being fat is the marker of beauty, desirability, and good character. Everywhere you look, there are images of happy fat people wearing the best clothes, driving the best cars, getting the hot dates, and landing the best jobs. Would you still feel bad about yourself? Would you still feel like you have to lose weight in order to get what you want and need in life? Probably not. Even if you still felt bad about yourself, you wouldn’t be focused on your weight, but rather on something else that your culture didn’t like—the size of your feet, or the slope of your nose, for example. But we do live in a society that confronts us with very negative messages about being fat. Most of us start absorbing these messages as we are just learning to talk, and they soon become a big part of how we view and evaluate ourselves, explain the things that happen to us, and decide what needs to change if we want to feel and do better. And sadly, it usually isn’t enough to simply recognize that “fat-loathing” is just a cultural prejudice you can choose to reject. You have to replace it with something equally as powerful, and that’s hard to come by after years of being conditioned to hate your own body. For many, the idea of accepting yourself and loving yourself sounds good, but it just doesn’t have the same emotional force that your negative self-image does. So you find yourself being pulled back to that negative image over and over again, and remaining stuck in the motivational problems it causes. But you can use your imagination to break the power of your negative self-image and replace it with something equally powerful. Here are some suggestions: Imagine that your negative body image isn’t really yours. Imagine someone
else planted it in your head to keep you trapped in an endless quest for a better body. Imagine who this “someone else” is and why they’ve done this. You could imagine, for example, that a secret group of very rich and powerful people use the media, fashion and advertising industries to convince people that they need to be thin, hard-bodied, and youthful to be happy, so they’ll keep buying diet books, magazines and gimmicks. Whatever story you come up with, create one that makes you feel angry that someone else could take advantage of you this way. Imagine that the negative body image implanted in your brain has suddenly been removed. You wake up one morning, look in the mirror, and don’t have any reactions at all. You know how you used to react and why, but realize that all those old feelings and thoughts weren’t yours. Imagine that you’re very determined not to let them back in again. What are your real feelings and thoughts about your body? Take some time to look yourself over thoroughly, touch your skin, move around, notice all the sensations you’re experiencing, and so on. Spend a few days going through your regular routines—getting dressed, eating,
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working, exercising, and all the other things you do—paying close attention to what your body is doing at each moment and how it feels. Take notes, if you want to. After a few days, sit down and try to express in words how you feel about your body. What can it do, or not do? Which of those things make you feel good and give you pleasure, and which don’t? Are there any things you’d like to be doing more or less of, based on how they make you feel? By completing an exercise like this, you will discover the feelings, thoughts and beliefs that will provide the best fuel to keep your motivational fire burning. You will get out of your head (and away from its “programmed” image of your body), and into your actual body with an open mind. You will learn what your body needs and wants, what it is capable of doing, and what it can tell you about how to make choices and take actions that are satisfying and rewarding. You may be surprised to find out how easy it becomes to exercise regularly, eat well, and reach a healthy weight when you stop treating your amazing body as the problem, and start using it as the solution. Taken from www.sparkpeople.com
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Feb - Mar 2013
Nutrition and Teens: Too Much Water? Or A Guide for Parents Too Little?
By CYWH Staff, Boston Children’s Hospital
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amily members play an important role in helping teens to become healthier. It is much easier to cook, shop, and prepare tasty and nutritious meals and snacks when everyone is working on the same goals. Here are some nutrition and wellness tips for you and your family: • Be a good role model. Teens are influenced by what they see, so it is important for family members to follow a healthy lifestyle. If the entire family is active and eating well, teens are likely to follow. • Keep healthy foods in the house. If nutritious foods are available, your family is likely to make healthier choices. Stock the kitchen cabinets, refrigerator, and freezer with nutritious foods, such as fruits, vegetables, low-fat dairy products (yogurt, cheese, and milk), and whole grains (brown rice, whole wheat cereal, and whole grain bread). Consider having a bowl of fresh fruit on the kitchen table and place healthy snacks in the front of your refrigerator and pantry. • Grocery shop together. Plan a trip to the grocery store with your teen. Start by making a list of the foods you will need to buy. This will help keep you on track when you are at the store. Be sure to include items for breakfasts, lunches, dinners, snacks, and treats. Choose foods from all the food groups (fruits, vegetables, grains, proteins, and dairy proteins). This way, your family will have all the ingredients for healthy eating. • Cook and eat meals together. Learning how to cook is an important life lesson. Involve your teen with preparing healthy meals. Instead of frying foods, use healthier ways to prepare foods such as baking, grilling, steaming, or microwaving. Eating together may be challenging because of family members busy schedules and commitments, which may often occur during meal times. Try your best to make eating meals together a priority. Talking and connecting with your teen is an important part of family time and it will also help slow down the pace of the meal to prevent overeating. • Eat healthy portion sizes. People often eat all the food on their plate regardless of hunger. Provide a range of foods including protein, whole grains, and
vegetables. Try serving a well-balanced plate that is about ½ vegetables, ¼ protein, and ¼ grain, such as pasta, rice, potatoes, or bread. If your teen is still hungry, then she can have an additional serving of the nutritious foods provided. • Eat at home most of the time. Fast food is higher in fat, salt, and calories than most meals prepared at home. Also, portion sizes at fast food and other restaurants are usually too large, and can lead to weight gain. Limiting the fast food meals you eat as a family will improve your health and the health of your teen. • Watch for hidden calories in drinks. Drinks such as juice, regular soda, and sports drinks are high in calories but are not very nutritious or filling. Drink mostly water or buy sugar-free beverages such as Fruit20®, Crystal Light®, sugar-free seltzer, and diet soda. Drinking high-fat or sweetened milk also adds excess calories, so choose low-fat plain milk (skim or 1%). • Have treats in moderation. Extreme dieting or fasting can be dangerous and is not successful for long term weight control. Healthy eating involves balancing nutritious foods with occasional treats. Having treats in the house can be very tempting for some people, so talk to your teen about what feels comfortable to them. It may be better for your family to go out for treats, or buy them in single serving packages. • Make small behavior changes. Permanent changes in health happen with small steps, not with strict dieting. Focus on making concrete small changes, such as drinking less regular soda and juice, eating more fruits and vegetables, or eating less fast food. Making small changes as a family can lead to great health benefits. • Select healthy snacks and meals. Help your teen select healthy snacks for after school and meals when eating away from home. Buy healthy portable backpack snacks (such as a piece of fruit, a granola bar, or trail mix) so your teen won’t buy a candy bar at the convenience store after school, or pack a healthy lunch for your teen to take school so she won’t be tempted to buy the cafeteria pizza and soda. Written and reviewed by the CYWH Staff at Boston Children’s Hospital Updated: 6/17/2010
By Maren Sederquist
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fter being told we need to make sure we stay hydrated for most of our lives, this spring, headlines across the country warned us we could die of too much water! They were great headlines, but misleading. While the risk of hyponatremia – the potentially fatal lowering of sodium levels by diluting your blood – is real, dehydration is still far more common. The New England Journal of Medicine published a study involving 488 runners who participated in the 2002 Boston Marathon (Volume 352:1550-1556, April 14, 2005, Number 15). A woman died during the marathon, after gulping 16 ounces of a sports drink. She’d already been running for five hours at mile 20. The study showed that the only few runners at risk for hyponatremia were those who were non-elite runners, with body mass index extremes, who gained weight while running, and had been running longer than 4 hours. While the risk is real, it is for a very limited percentage of the population. We don’t hear of many people dying of dehydration because the dangers are so well known that they are taken care of. There are always tents full of people who are exhausted and have collapsed, getting IV fluids after endurance races. That’s what saves their lives! So, drink your water. Make it a sports drink to replenish electrolytes if you’re going to be exercising for longer than an hour, or if you’re a salty sweater. And weigh yourself before and after workouts to adjust your fluid intake, if you’re going to be exercising longer than a couple of hours. If you feel thirsty, you may already be dehydrated, so drink up! “Water makes up more than 70% of solid body tissue and helps regulate body temperature, carry nutrients and oxygen to cells, remove waste, cushion joints, and protect organs and tissues. Lack of adequate water intake leads to headaches, grogginess and dry, itchy skin. Severe dehydration affects blood pressure, circulation, digestion, kidney function, and nearly all body processes.” (http:// www.healthcentral.com) Symptoms of Hyponatremia Early Signs
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• • • • •
Post workout weight gain Throbbing headaches Bloating Nausea Grogginess
Severe Sign • Brain Swelling Symptoms of Dehydration (Even one sign can mean you’re dehydrated!) Early Signs • Fatigue • Headache • Appetite loss • Flushed skin • Heat intolerance • Light-headedness • Dark urine with a strong odor • Muscle cramps • Dulled thinking Severe Signs • Difficulty swallowing • Stumbling • Clumsiness • Shriveled skin • Sunken eyes and dim vision • Painful urination • Numb skin • Muscle spasms • Delirium • Fainting • Heart attack “Maren Sederquist, MES, CSCS, CPT, is an internationally recognized fitness expert and owner of HealthFIT Professional Training, a personal training and fitness consulting firm providing inhome training in Silicon Valley. She is the publisher of HealthFIT News - a monthly newsletter, and the HealthFIT News Blog, both devoted to keeping its readers fit for health and wellness. Subscription information, as well as past articles and tips, can be found online at http://www. healthfitonline.com or by writing to maren@healthfitonline.com. Maren is also the founder of KidLifting, creating healthy families with exercises for parents to do with their kids. The DVD, articles and forum can be found at http://www. kidlifting.com.”
Feb - Mar 2013
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Feb - Mar 2013
If I’d Had To Wait Until 67 For Medicare, I’d Be Dead By Judy Ford
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am Lewis turned 65 in the nick of time. For a year, he’d been broke. His Brentwood, Calif., general contracting business had gone bust. He couldn’t make payments on his home, and lost it. He couldn’t make payments on his health insurance, so he let it lapse. The day after his birthday in October, when he qualified for Medicare, Lewis got a checkup. Days later, he went under the knife: open-heart surgery, a triple-bypass, three arteries blocked with plaque, one of them, 99 percent. “If I’d had to wait until 67 for Medicare,” Lewis said, “I’d be dead.” A proposal to raise the Medicare eligibility age from 65 to 67 to ratchet down spending is one of the more explosive ideas in the fiscal talks between House Speaker John Boehner and the White House. The negotiations are aimed at a deficit deal to avert automatic tax increases and spending cuts slated to take effect Jan. 1. Liberal Democrats say they loathe the Medicare proposal, but the White House has not taken a public position on it. President Barack Obama was open to a similar proposal last year during his failed effort to reach a “grand bargain” with Republicans. And many expect it to pop up again in next year’s discussions about curbing entitlement costs if it is not included in this year’s deal. Whatever the politics, those approaching retirement are responding with anger and fear, while employers see themselves stuck holding the bag on long-ago social commitments made by the federal government. “All they’re doing is shoving the cost onto the backs of business,” said Don Marks, president of Uesco Industries in Alsip, Ill., a family-owned company that assembles overhead cranes and hoists used in manufacturing plants. Uesco employs 45 people and pays some medical expenses of retirees that are not picked up by Medicare. With no set retirement age, the company would pay health insurance costs for older, likely sicker workers who might no longer retire at 65 because they would not be eligible for Medicare.
In his business, Marks sees little good coming from that. “We are a heavy metal manufacturer,” he said. “It’s big and heavy pieces of steel that we move around, that we grind, that we weld, that we cut with torches. It’s heavy labor. The older (the workers) get, the more it costs for health insurance. And we have an aging workforce.” Kevin Kelly, CEO at Emerald Packaging in Union City, Calif., is also unhappy about the proposal. “I don’t think the government or legislators are thinking about the impact this will have on business,” he said. Emerald employs 225 workers to manufacture plastic bags for produce sold at grocery stores -- five of them between the ages of 63 and 65. Kelly figures it would cost him an extra $120,000 annually to pay for health insurance for those five workers for another two years. “It comes right out of profit,” he said. “It’s not like I can raise prices because the government decided not to cover people between 65 and 67. If I try to pass the cost to the retailers, it just gives them one more reason to look to China.” Proponents of the idea such as Gail Wilensky, who oversaw Medicare and Medicaid for the first President George Bush, say people are living longer than when the program was enacted in 1965 and it’s important to raise the eligibility age gradually to change younger Americans’ perceptions about what they can expect from entitlement programs. “What we need is to try to find ways to try to encourage people to participate in the labor force longer, and not only for our sake but for their sake as well,” Wilensky said at a forum this week, noting the number of beneficiaries is expected to double over the next two decades as Baby Boomers retire. The Congressional Budget Office estimates the potential net savings to the federal government from gradually raising the eligibility age to 67 beginning in 2014 at approximately $113 billion over 10 years, as older workers remain in the work force longer, and pay Medicare taxes while giving up benefits for two more years. But cost shifting to workers and
employers would increase out-of-pocket costs for 65- and 66-year-olds by $3.7 billion a year and boost employers’ health care costs by $4.5 billion, according to a 2011 analysis by the Kaiser Family Foundation (Kaiser Health News is an editorially independent program of the foundation). The potential human toll is harder to figure. Like Sam Lewis says, many in their early sixties who lack insurance are “crossing fingers, walking on tiptoes, and making sure not to break any eggs,” until they turn 65. Some may not be as lucky as him. The left-leaning Center for American Progress projects that raising the Medicare age could put up to 435,000 older people at risk of having no insurance at all, even with the protections afforded by the health care law – although the CBO’s estimate is far lower. The health law changes the equation after 2014 since insurers will no longer be able to refuse applicants because of preexisting health conditions, or charge older people more than three times what they charge young people. In addition, the state and federal health insurance marketplaces planned for 2014 will offer subsidies to help those with lowincomes buy health insurance, and states that expand Medicaid will cover single adults. But will it be enough to tide people over until they qualify for Medicare -especially since some governors say they won’t expand Medicaid and the effect of
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the exchanges on insurance affordability remains untested? Realtor Mary Nishiyama, 57, a friend of Lewis, is not confident. “There is going to be a big wave of us,” she warned. “Don’t they know our parts aren’t working as well as they used to?” Nishiyama pays $800 a month for coverage which she buys at group rates through her former employer, Chevron, and has recently started saving in case she has to wait another two years before qualifying for Medicare benefits. “If you don’t have money to put away, how are you going to pay for your health care?” Even some who consider themselves physically and financially healthy say they’re furious about upending a social contract they’ve spent a lifetime paying into – and expecting to be there for them. “They’d be pulling the rug out from under us,” said Chuck Hinkle, 56, a gas pipeline electrician in Oak Forest Ill., who points out he’s been paying into Medicare his whole working life. The fact that increasing health costs are threatening to consume the federal budget, especially as people live longer and millions of Baby Boomers retire, is an abstraction. “I’m still planning to retire at 65,” Hinkle said. “I’m hoping to be in a financial position where I can just cough up the money for those two years.” This article was produced by Kaiser Health News with support from The SCAN Foundation. We want to hear from you: Contact Kaiser Health News
Feb - Mar 2013
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Feb - Mar 2013
Eat Potassium Rich Foods to Lower Blood Pressure By Richard M Harrison
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he foods below all contain high levels of potassium. Potassium is one of four essential electrolytes (sodium, potassium, calcium and magnesium) used in the body. Potassium helps to lower high blood pressure by counteracting the negative effect of sodium. Too much sodium makes your body hold onto excess fluid which leads to an increase in blood volume which in turn increases blood pressure. Potassium helps your kidneys expel sodium and excess fluid from the body which lowers blood pressure due to the reduction in fluid volume. Note: University of Pennsylvania researchers discovered that just 10 days of potassium restriction in the diet increased blood pressure for both people with normal and raised blood pressure. Most people eat way too much salt/ sodium (salt is comprised of 40% sodium and 60% chloride) and not enough potassium so you have a double negative. The goal here is to increase consumption of potassium rich foods to counteract the negative effect of salt. However to get the maximum benefit from this it is also recommended to cut back on the salt as well. Note: Both the American Heart Association and the Blood Pressure Association in the UK recommend eating a diet high in potassium to help lower high blood pressure. Additionally most national health authorities now recommend increasing potassium consumption via diet along with reducing sodium intake. Below are some of the main high potassium fruit and vegetables. Fruit and vegetables contain the highest amount of potassium of any food type. The only other notable source of potassium is dairy products. Dairy also has the benefit of being high in calcium and should be included daily in your diet, but be sure to choose low fat dairy options. High Potassium Vegetables Artichoke Baked beans (can be high in salt!) Butternut squash Beetroot All beans and peas Cabbage Cucumber Carrots Brussels sprouts Lentils Mushrooms Potatoes Parsnips Spinach Tomatoes Cauliflower Broccoli Sweet Potato Celery Kale High Potassium Fruits/Nuts/Seeds
Apple Avocado Bananas Dried dates Dried apricots Figs Kiwi fruit Mango Orange and orange juice Papaya Strawberries Watermelon Raisins Prunes and prune juice Pear Nectarines Grapefruit Pomegranate Sunflower seeds Pumpkin seeds Peanuts Brazil nuts Almonds To help lower blood pressure try to eat 5 portions of the high potassium fruit and vegetables a day (a simple guide to portion size is a portion is roughly the size of your closed fist). The way I managed to up my potassium rich food was by including the vegetables in main meals and snacking on the fruit, nuts and seeds when hungry in between meals. I also found dried fruit useful for adding variety. This might seem difficult to begin with but give it a go and once you start try and stick with it as the benefits and the reduction in blood pressure happens of several weeks and months. I found it got much easier after the first week as it became more of a habit. If you really are struggling to eat 5 portions a day any increase will be beneficial and is worth the effort. For example a small study showed that eating two bananas a day had a positive and measurable reduction in blood pressure. Note: increasing calcium and magnesium has also been shown to help lower blood pressure. Many of the high potassium foods also contain calcium or magnesium. Not only will upping the fruit and vegetables help to lower your blood pressure, but all the additional vitamins, minerals and fibre will also help you avoid certain cancers, bowel problems, heart attacks and lower cholesterol. You’ll also likely have more energy and look and feel better! An additional benefit that has recently been reported in the journal Stroke states that people eating lots of potassium rich foods have a reduced risk of stroke. The report says that for each 1,000-milligram (mg) increase in daily potassium, the odds of suffering a stroke in the next five to 14 years declined by 11 percent. The researchers do state that the findings do not prove that it is just the potassium alone in the potassium rich food which produces
the positive effect, but who cares! The science that potassium helps to lower blood pressure can’t be ignored. It has simply been proven so many times. On a personal level, after following a higher potassium diet for two months my blood pressure dropped by approximately 10 systolic and 5 diastolic. I only had stage 1 high blood pressure and many studies have shown that higher the blood pressure to begin with, results in greater the reduction in blood pressure. Note: supplementation with potassium tablets is not advised. Excessive intake of
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potassium can lead to a condition known as Hyperkalemia in people with compromised kidney function. The recommended intake of potassium is 4.7mg per day. Providing you do not go too far over this via your diet you will be fine. If you do have a kidney problem consult your doctor before increasing your potassium intake.
Feb - Mar 2013
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Feb - Mar 2013
Americans Uncomfortable Around Mentally Ill Despite Acknowledging Discrimination By Jordan Rau
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he public has a contradictory view of mental illness, according to a new poll. While most Americans believe people with such ailments are the victims of prejudice and discrimination, a substantial portion of the public say they have qualms about working in the same place or having their children attend a school where someone with a “serious” mental illness is employed. Seventy-six percent of Americans believe the mentally ill experience discrimination, according to the poll from the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.) That was a greater portion of Americans than those who said they thought discrimination burdens people with HIV or AIDS; Hispanics; blacks; people with physical disabilities, or women. Immigrants were the only group to rank higher than those with mental illness. But the pollsters noted that that the survey “suggests that many Americans are themselves uncomfortable with the idea of interacting with people who have a serious mental illness.” Sixty-six percent of parents said they would be “very” or “somewhat’ uncomfortable if a person with a serious mental illnesses worked in their
child’s school. Forty-seven percent said they would be uncomfortable living next door to someone with a serious mental illness, and 41 percent said they were uncomfortable working with someone who has a serious mental illness. These concerns were less severe among people under 30, and people with their own mental health issues or experiences with family members. The poll questions were prompted by the Newtown, Conn., elementary school shooting on Dec. 14 and the subsequent debate about whether stronger gun control laws and better mental health services might prevent similar attacks. The poll also found a post-election drop in popularity for the 2010 health care law, which had been narrowly more popular than not in November. This month, 42 percent of Americans expressed an unfavorable opinion of the law and 36 percent said had a favorable opinion. Another 23 percent either said they didn’t know or refused to answer the question— the most that dodged the issue in the nearly three years that Kaiser has been testing public perceptions about the law. The pollsters attributed the change to a drop in support among Democrats. The poll was conducted Feb. 14 through
Feb 19 among 1,209 adults. The margin of SCAN Foundation. error was +/- 3 percentage points. We want to hear from you: Contact This article was produced by Kaiser Kaiser Health News Health News with support from The
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New Coverage May
Spur Younger Women To Use Long-Acting Contraceptives By Michelle Andrews
E
ven though they’re more effective at preventing pregnancy than most other forms of contraception, long-acting birthcontrol methods such as intrauterine devices and hormonal implants have been a tough sell for women, especially younger ones. But changes in health-care laws and the introduction of the first new IUD in 12 years may make these methods more attractive. Increased interest in the devices could benefit younger women because of their high rates of unintended pregnancy, according to experts in women’s reproductive health. IUDs and the hormonal implant -- a matchstick-sized rod that is inserted under the skin of the arm that releases pregnancypreventing hormones for up to three years -- generally cost between $400 and $1,000. The steep upfront cost has deterred many women from trying them, women’s health advocates say, even though they are costeffective in the long run compared with other methods, because they last far longer. Under the Affordable Care Act, new plans or those that lose their grandfathered status are required to provide a range of preventive benefits, including birth control, without patient cost-sharing. Yet even when insurance is covering the cost of the device and insertion, some plans may require women to pick up related expenses, such as lab charges. More From This Series Insuring Your Health Long-acting reversible contraceptives (LARCs) require no effort once they’re put into place, so they can be an appealing birth-control option for teens and young women, whose rates of unintended pregnancy are highest, experts say. Across all age groups, nearly half of pregnancies are unintended, but younger women’s rates are significantly higher, according to a 2011 study from the Guttmacher Institute, a reproductive health research organization. Eighty-two percent of pregnancies among 15- to 19-year-olds were unintended in 2006, and 64 percent of those among young women age 20 to 24 were unintended, the study found. Although the use of LARCs has more than doubled in recent years, it is a small part of the contraceptive market. Among women who use birth control, 8.5 percent of women used one of those methods in 2009, according to the Guttmacher Institute. The use of LARCs by teenagers was significantly lower at 4.5 percent, while 8.3 percent of 20- to 24-year-olds chose this type of contraception.
In October, the American College of Obstetricians and Gynecologists reiterated its strong support for the use of LARCs in young women. Yet many young women are unaware that long-acting methods could be good options for them, in part because their doctors may be reluctant to prescribe them, experts say. That is partly the legacy of the Dalkon Shield, an IUD that was introduced in the 1970s whose serious defects caused pain, bleeding, perforations in the uterus and sterility among some users. The problems led to litigation that resulted in nearly $3 billion in payments to more than 200,000 women. In addition, providers may hesitate because there’s a slightly higher risk that younger women will expel the device, experts say. But expulsion is a problem more likely associated with the size of the uterus, which is not necessarily related to a patient’s age, says Tina Raine-Bennett, research director at the Women’s Health Research Institute at Kaiser Permanente Northern California and chairwoman of the ACOG committee that released the revised opinion on LARCs. “Expulsion is only a problem if it goes unrecognized.” (Kaiser Health News is not affiliated with Kaiser Permanente.) The new IUD Skyla became available in mid-February. It is made by Bayer, the same company that makes Mirena, another IUD sold in the United States. Unlike Mirena, which is recommended for women who have had a child, Skyla has no such restrictions (nor does ParaGard, the third type of IUD sold here). Mirena is currently the subject of numerous lawsuits alleging some complications, such as device dislocation and expulsion. Skyla is slightly smaller than the other two IUDs on the market and is designed to protect against pregnancy for up to three years, a shorter time frame than the others. This shorter time frame may make Skyla more attractive to younger women who think they may want to get pregnant relatively soon, some experts say, although any IUD can be removed at any time. “More providers are spreading the word that it’s okay, and more young women are demanding it,” says Eve Espey, a professor of obstetrics and gynecology at the University of New Mexico. This article was produced by Kaiser Health News with support from The SCAN Foundation. Please send comments or ideas for future topics for the Insuring Your Health column to questions@kaiserhealthnews.org.
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