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S I M P LY W E L L We l l n e s s T i p s a n d E n c o u r a g e m e n t f ro m H e a l t h A l l i a n c e
WHAT’S INSIDE Immunizations
Catch Up on Your Vaccines–p. 2
Your Diabetic Eye Exam Blood Pressure and Diabetes–p. 4
Recipe
Blueberry Avocado Muffins–p. 6
The Weight Your BMI Carries Where’s Your BMI?–p. 10
qm-NWsimplywell-0718
Immunizations
Now’s the Time to Catch Up on Your Vaccines The worries of winter sickness have passed, but let’s not forget the power of staying current on your vaccines. Proven to be one of the easiest and safest actions you can take for your health, summer is the perfect time to talk to your doctor about getting up to date. About 85 percent of the world’s children receive vaccines protecting against tuberculosis, polio, diphtheria, tetanus, pertussis and measles. Source: Children’s Hospital of Philadelphia
These vaccines save about 2.5 million lives. Adult Vaccines
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Details
Tetanus, diphtheria and pertussis (Td/Tdap)
All adults, especially pregnant women.
Shingles
Healthy adults 50 years and older get two doses, separated by 2 to 6 months. Adults should get the Shingles vaccine called “Shingrix” even if they’ve had shingles, received Zostavax and/or are not sure if they’ve had chickenpox.
Children Chickenpox
Measles, Mumps, Rubella (MMR)
Details Between 12 and 15 months old, and a booster at 4 to 6 years of age. If a child between ages 6–12 hasn’t had chickenpox, they may receive the vaccine with the two doses given at least three months apart. First dose at 12 to 15 months of age, and the second dose at 4 through 6 years of age.
Note: These vaccines are recommended unless your doctor says you don’t need them or shouldn’t get them. Always follow your doctor’s advice about needed vaccines.
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Adult Vaccines
Details
Children
Details
HPV
Women ages 19–26 and men ages 19–21 who haven’t completed the vaccine series.
Hepatitis A and B
Hepatitis A: First dose at 12 through 23 months, and a second dose 6 months after the first. Hepatitis B: Three doses: first dose shortly after birth; 1 through 2 months; and 6 through 18 months. Your child may get a fourth dose depending on the brand of vaccine.
Chickenpox
Adults not vaccinated as a child.
HPV
Two shots at least 6 months apart at ages 11 or 12, finishing the two-shot series before their 13th birthday. Teens and young adults who haven’t received the vaccine should ask their doctor about it.
MMR
Adults not vaccinated as a child.
Diphtheria, tetanus and pertussis (DTaP)
Five doses; one dose at each of the following ages: 2 months, 4 months, 6 months, 15—18 months, 4 to 6 years.
Influenza (Flu)
All adults, once annually.
Rotovirus
Dosage is based on the type of vaccine used. RotaTeq® (RV5)—given in three doses at 2 months, 4 months and 6 months of age. Rotarix® (RV1)—given in two doses; at 2 months and 4 months of age.
Pneumococcal
All adults; get one dose of PCV13 and at least one dose of PPSV23, depending on age and health condition.
Polio
Four doses; one at each of the following ages: 2 months, 4 months, 6 through 18 months, 4 through 6 years.
This is not a complete list of vaccines. Go to CDC.gov to download the full list of recommended vaccines for adults and children. For coverage questions, call the Customer Service number on the back of your ID card.
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Make the Most of Your DIABETIC Eye Exam Diabetes doesn’t just require you to keep your medications in check—your eyes need attention, too. With diabetes, you’re at a higher risk for eye problems, like glaucoma, cataracts and diabetic retinopathy.
Glaucoma
Pressure within your eyeball, causing a slow loss of sight.
Cataracts
The lens of your eye(s) becomes cloudy, resulting in blurred vision.
Retinopathy
High blood sugar levels cause damage to the blood vessels in your retinas, a layer of nerves sensing light and sending signals to the brain so you can see. This disease can cause blindness. 4
Glaucoma and retinopathy don’t have symptoms until permanent damage is done. All three of these eye conditions worsen over time, so the sooner you can catch a problem, the better. The American Diabetes Association (ADA) recommends people with type 1 diabetes have a first eye exam within the first five years of being diagnosed. Those with type 2 diabetes should have their first diabetic eye exam shortly after being diagnosed. After that, you should get a yearly exam unless your doctor tells you otherwise.
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[ Symptoms to always discuss in your yearly checkup: • • • • • • • •
Blurred vision Trouble reading signs or books Seeing double Eye pain Lasting eye redness Eye pressure Seeing spots or floaters Straight lines not looking straight
Protect your eyes by taking action now.
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Also, jot down the following: • When your symptoms happen • What your blood glucose levels are at the time of the problem • A list of any other health issues you’re having, along with when they happen and for how long
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Blueberry Avocado Muffins h t i w Lemon Streusel Topping
You’re probably thinking, “Avocado in a muffin? That’s not right.”
Muffins
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But this recipe is not only picky-eater-tested and approved … the avocado is nearly tasteless, and it replaces the oil and butter usually found in muffins.
Ingredients –1 –¾ –¼ –2 –½ –½
cup all-purpose flour cup whole wheat flour cup ground flaxseed teaspoons baking powder teaspoon baking soda teaspoon salt
–1 –¾ –1 –1 –1 – 1½
large, ripe Hass avocado, pitted cup sugar large egg teaspoon vanilla extract cup plain Greek yogurt cups fresh blueberries
Instructions 1. Preheat the oven to 375°F. Place silicone or paper liners in a 15-cup muffin pan or coat the cups with cooking spray. 2. In a medium bowl, mix together the flours, flaxseed, baking powder, baking soda and salt. 3. Spoon the avocado flesh into a mixing bowl. Beat on low until almost smooth. With the mixer still running on low, add the sugar. Once the sugar is mixed in, beat in the egg. Add the vanilla and yogurt. Mix well. 4. Slowly add the flour mixture to the wet ingredients and mix until just blended. Be sure not to overmix. At this point, the batter will be a bit thick. Using a spoon, gently fold in the blueberries. 5. Fill the muffin cups about three-fourths full, leaving room for the streusel topping. 6. To make the streusel topping: In a medium bowl, combine the flour, sugar, and lemon zest. Using a pastry cutter or a fork, cut in the butter until it resembles coarse crumbles. 7. Sprinkle the streusel topping evenly over the batter. 8. Bake for 25 to 30 minutes, or until a toothpick inserted in the center of a muffin comes out clean. Let the muffins cool in the pan on a rack for 5 to 10 minutes before removing.
Recipe from ThrivingHomeBlog.com
Lemon Streusel Topping (Optional) Ingredients –¼ –13 –1 –3
cup whole wheat flour cup sugar teaspoon grated lemon zest tablespoons unsalted butter, cut into small pieces
9. Serve warm or at room temperature. To freeze After the muffins have cooled, place them in an airtight freezer container or freezer bag. To prepare from frozen Wrap a frozen muffin in a moist paper towel and microwave in 30- to 60-second increments until warmed all the way through. If you want to use frozen blueberries, just toss them in a bit of flour before stirring them into the mixture. This will prevent them from sinking to the bottom. The streusel topping is optional. Feel free to leave it off if you are trying to avoid added sugar.
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– ½ teaspoon salt
– 1½ cups fresh blueberries
Take Control: Create a Healthier You by Knowing Your Numbers
Put a thermometer in your mouth, and it’s pretty easy for you to see whether your temperature is too high. Strap a blood pressure cuff to your arm, and things aren’t as clear. “What in the world does 120/70 or 130/80 really mean?” Your reading might sound like gibberish, but it’s critical to understand (especially if you or your family has a history of high blood pressure).
Blood Pressure 101 Why is Blood Pressure So Important? Simply stated—it’s what keeps you alive! When your heart beats, it pumps blood around your entire body (all the way down to your toes), giving it the energy and oxygen needed. As your blood moves, it pushes against the sides of the blood vessels, and this pushing and relaxing is what equals your blood pressure. What Do the Numbers Mean? Top Number = Systolic pressure, or the pressure your heart puts out to pump blood into your bloodstream Bottom Number = Diastolic pressure, or the time when your heart is filling and getting ready for its next big pump (relaxation phase) mm Hg = A millimeter of mercury, or a manometric unit of pressure
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What’s Normal? It’s changed. After 14 years, the American Heart Association/American College of Cardiology updated its definition in November 2017. Make sure your blood pressure is controlled. The categories now look like this: • Normal: Less than 120/80 mm Hg • Elevated: Top number (systolic) between 120–129 and bottom number (diastolic) less than 80 mm Hg • Stage 1: Systolic 130–139 or diastolic 80–89 mm Hg • Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg • Uncontrolled high blood pressure: Top number over 180 and/or bottom number over 120; see your physician within 24 hours. If you have severe headache, chest pain, shortness of breath or any vision or movement loss, go to the emergency room. What Can Happen When It’s High? Your blood pressure plays a key role in you keeping your quality of life. When it’s higher than normal, your risk of danger is higher. And when left uncontrolled, it can lead to: • Heart attack—arteries can become blocked and prevent blood from flowing to your tissue in the heart • Stroke—your blood vessels in your brain may burst or clog more easily • Heart failure—your heart enlarges and doesn’t supply blood to the body • Kidney disease or failure—arteries around your kidneys become damaged, making filtering your blood hard
: You Can! • Vision loss—your eyes’ blood vessels may be strained or damaged • Sexual dysfunction—erectile dysfunction for men or low libido in women • Angina (not enough blood to heart)—extreme pain in the chest, sometimes spreading to the shoulders, arms and neck • Peripheral artery disease (PAD)—your arteries may narrow in the legs, arms, stomach and head, leading to pain or fatigue Keeping Your Blood Pressure in Check Diet and exercise are key (along with taking your medicines as ordered by your doctor). When you stay in control of what you eat and how much you move, your blood pressure will respond. In research studies, people using the DASH diet lowered their blood pressure within just two weeks. As for exercise, don’t think you've got to run a marathon to affect your numbers. Becoming more active can drop your top number (systolic blood pressure) by 4 to 9 mm Hg. That's as good as some blood pressure medications.
DASH Diet DASH stands for Dietary Approaches to Stop Hypertension (Dashdiet.org). It focuses on filling your plate with fruits, veggies and low-fat dairy. It includes some fish, poultry and legumes with a small amount of nuts and seeds a few times a week. The Dietary Guidelines for Americans say to keep daily sodium intake to less than 2,300 milligrams (mg) a day, but the American Heart Association recommends less than 1,500 mg a day of sodium for all adults. If you aren't sure what sodium level is right for you, talk to your doctor.
DID YOU KNOW? 1 tsp of table salt = 2,325 mg of sodium Take a look at the recommended servings from each food group for a 2,000-calorie-a-day DASH diet. • Grains: 6 to 8 servings a day (choose whole grains) • Vegetables: 4 to 5 servings a day • Fruits: 4 to 5 servings a day • Dairy: 2 to 3 servings a day • Lean meat, poultry and fish: 6 servings or fewer a day • Nuts, seeds and legumes: 4 to 5 servings a week • Fats and oils: 2 to 3 servings a day • Sweets: 5 servings or fewer a week Now is the time to start making small changes. First, try limiting yourself to 2,300 mg of sodium per day* (about 1 teaspoon), and add a short walk around the block three times a week. Then, once you feel good about your progress, cut back to 1,500 mg (about 2/3 teaspoon) of sodium per day, and push yourself to walk a little further and a little more often. You may not be able to change every factor affecting your blood pressure, but for the things you can—take control. Remember to always consult your doctor before making changes to your lifestyle.
*These amounts include sodium in prepared foods, along with what you cook with and/or add at the table.
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What’s Your BMI?
BMI = (Weight in pounds x 703) (Height in inches x height in inches)
The
Your BMI Carries
Hop on your bathroom scale, and you might think, “My weight is just right.” But it’s missing an important measure: Body Max Index (BMI). Your BMI takes into account your height and weight, giving you a better understanding of your weight status (i.e. underweight, overweight or within a healthy weight range). This is not a precise measure, but it’s a good starting point to flag weight-related health conditions, like diabetes, high blood pressure and heart disease.
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Weight
Also, think about where you carry your weight. Experts say this makes a big difference to your health. When you carry extra weight around your waist, it could be a sign you have too much of what’s called “visceral fat.” Visceral fat, also called abdominal fat, settles behind your stomach muscles and around important organs, pushing on them and making it harder to move blood through your body. A simple measurement around your waist (just above your hip bones) can tell you whether you have too much waist fat. A healthy cutoff is less than 35 inches for women and less than 40 inches for men. For people of Asian descent, it’s less than 31.5 inches for women and less than 35.5 inches for men.
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Though genetics play a role in where extra pounds settle on your body (and the aging process doesn’t help), the good news is that visceral fat responds really well to diet and exercise.
Get Moving Aerobic exercise (cardio) helps you keep your weight under control. Speed walking, stair climbing, cycling and swimming are great ways to get moving.
Build Strength Strength training helps you keep or increase your muscle mass. And because you have more muscle, you’ll actually burn more calories. Focus on doing exercises using your own body weight. When you’ve mastered those, add two-and-half-pound or five-pound weights. Squats, push-ups and lunges are perfect exercises to get started.
Eat Well There are thousands of diets, and the most tried and true method is: whole grains, fresh fruits and vegetables, lean protein and some healthy fats. You might even think about trying the DASH diet on page 9.
Get Rest Studies show a link between weight gain and not enough sleep. Most people need seven to nine hours a night, so do your best to get some good sleep. If you don’t feel like you’re getting restful sleep, talk to your doctor. Although no single number will ever give you a perfect measure of your health, they are a place to start your journey toward a healthier you. Know the weight your numbers carry—and don’t be afraid to change them. 11
Health and wellness or prevention information
If you’re planning to travel out of the country, you (and your child) might need additional vaccines before you leave. Along with asking your doctor what’s best, visit CDC.gov/Travel for more info. Most vaccines are needed at least four to six weeks before heading off.
316 Fifth St. Wenatchee, WA 98801
Traveling This Summer?
Like eating well and exercising, vaccines are another must for your health!
Health Alliance Northwest is a Medicare Advantage Organization with a Medicare contract. Enrollment in Health Alliance Northwest depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. ATTENTION: If you speak Spanish, language assistance services, free of charge, are available to you. Call 1-877-750-3350 (TTY: 711). ATENCIÓN : Si habla Español, servicios de asistencia lingüística, de forma gratuita, están disponibles para usted. Llame 1-877-750-3350 (TTY: 711). Benefits for expenses incurred for services or treatment are subject to the plan terms in effect on the date services or treatment are received. Call the Customer Service number on the back of your ID card to check your coverage. qm-NWsimplywell-0718