Healthy Magazine | Holiday Issue 2018 by Healthy Magazine

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THE HEALTHY HOLIDAY ISSUE 2018

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2018 Holidays VOL. XVIII â&#x201E;&#x2013; 6

e c a e p # 6 HEALTHY MAGAZINE 2018

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CHOICE. M

aybe it's all this talk about voting, politics

and working /non-working websites, and covering healthcare, getting healthy or making un-healthy choices, but I've been thinking a lot about the choices we make and how they relate to success in life, at all levels.

Consider the American diet. If we really want to improve the health of Americans, why is it that healthier foods are so much more expensive, and junk foods so much more prevalent? I'll admit, my eating choices have been squarely in the un-healthy category lately. My diet has failed and I'm up ten pounds in 2013. Yet, I've made progress in a number of other areas. So, I've come to realize that failure can be an educational step, and success is a choice. Ponder that for a moment. We can choose to succeed, and conversely, failure is a choice—a decision we make. Success is optional—literally an ‘option’ for us to select. We can choose failure, or success. I love the classic Tony Robbins question:

“What would you attempt to do if you knew that you couldn’t fail?”

The obvious answer is that if you knew you couldn’t fail, you’d do almost anything—and everything. If that's true, the logical next question is, why don’t we? If failure is optional, why don’t we simply choose success? If you say you’d do almost anything, then just go do it. If you set up the right ‘rules’ and habits, if you're willing to pay the price, it’s virtually impossible for you to fail. In sports, not every play scores. In fact, plays in sports are often

P H O T O B Y T I F F I N E E D AW N . C O M

WRIT TEN BY JOHN A. ANDERSON, EDITOR IN CHIEF

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Healthy

EDITOR'S NOTE

HOLIDAYS 2018 VOLUME XVIII, 6

unsuccessful. You ran a play. It didn’t work. But as long as you’re on the field and the time is still ticking (or your heart, for the purposes of this magazine), then you’re still in the game. Keep playing, and drawing up new plays. Try something else, change your approach, and eventually you’ll succeed. Remember the classic Babe Ruth quote when asked what he thought about after he’d strike out – “I think about hitting home runs.” It all sounds great, but is it practical? Is it possible to simply ‘choose’ to change? I’ve had close friends say it’s too simplistic; that this positive stuff might work in parenting and relationships, but not for teams, business endeavors or other measurable applications. However, countless success stories and marked turnarounds (individual and corporate) began with a moment of decision and positive inertia. The Law of Attraction states that we eventually become what we want—what we think about. We literally attract what we want and ponder—positive and negative. Clearly, a first step towards healthy change is a basic desire to change, and then the visualization of achieving the success. Breaking free in any venture starts by answering the question for yourself – “If you knew you couldn’t fail, what would you attempt?” Sometimes we never ask that question because we are so afraid of failure. And sometimes we don’t answer it because we are afraid of success. I feel strongly that success in any endeavor is based on the belief that the past does not equal the future. Since failure is simply persisting in doing something that doesn’t work, success begins by changing your state, your physiology, and in many cases, your psychology. What you’ve done your whole life—all last month, all day yesterday—doesn’t matter half as much as what are you going to do now. Today. And tomorrow. We’ve got to learn how to let go of the negative luggage we carry around. Set it down and move on. Simple to say, I know, but you’ve first got to choose to move on. You’ve got to link ‘pleasure’ with making the change. Then you’ve got to calculate the cost of not changing and moving on. You’ve got to link ‘pain’ with not changing. That acts as leverage to keep you moving forward towards success. Either way, it’s your choice. I hope this gets you thinking and hopefully helps you take stock of where you’ve been, and where you plan to be this time next year. Remember, it’s impossible to fail unless we give up. Choose to succeed.

EDITOR-IN-CHIEF John A. Anderson | john@leadfront.io PUBLISHER Kenneth J. Shepherd | ken@leadfront.io MEDICAL DIRECTORS Steven N. Gange, M.D. and Lane C. Childs, M.D. OPERATIONS MANAGER Allyson Long | allyson@leadfront.io DESIGN EDITOR Phillip Chadwick | phil@leadfront.io MANAGING EDITOR Michael Richardson | michael@leadfront.io ONLINE EDITOR Marlo Anderson | marlo@leadfront.io ASSISTANT DESIGNER Krista Bowen | krista@leadfront.io CONTRIBUTING & STAFF WRITERS Caitlin Schille, Angela Silva ONLINE DIGITAL PUBLICATION

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FITNESS

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FITNESS

(Un)Healthy CONSCIENCE In order to be healthy, you have to know what to put into your body to achieve your specific goals. Inversely, you can be sabotaging all of your hard work if you are eating the wrong foods. Your intentions may be good, but you may be putting things in your body that are limiting your progress. One of my favorite sayings is, “You can work out ‘til you’re blue in the face, but if you’re not eating right you will not get anywhere.” When it comes to “un”healthy, here are the 5 worst things that you can put in your body that are popular inside the gym:

5. Soy protein – To build muscle, you need more than protein. Soy contributes to raising estrogen levels and converting testosterone into estrogen. When digested, protein gets broken down into chains of amino acids and then testosterone builds lean muscle out of these chains of amino acids. On top of that, 90% of soy grown on the planet is genetically modified.

4. Fruit juice – You may have the best of intentions, but drinks like orange juice and apple juice have tons of sugar. Even drinks that say 100% fruit juice have added sugar. High amounts of sugar will cause you to lose steam, feel dizzy, or crash during a workout.

3. Breakfast – Hold on, allow me to explain myself.

The common mis-conception is that you should eat as soon as you wake up to jump start your metabolism. There is no research supporting this and I used to preach this myself. If you wait 2-3 hours after you wake up you will get a much larger spike in growth hormone which will boost metabolism.

2. Energy Drinks – I see people drinking these in the gym when they are tired or low on energy. These drinks overload your body with caffeine and sugar. Manufacturers have to include taurine (a free form amino acid) in their drinks to counteract the large amounts of caffeine and suger and keep your heart calm. Stick with coffee.

1. Diet Soda (and regular soda) – We all know soda is horrible for us. What we may or may not know is diet soda is equally as bad. Diet soda spikes your insulin and causes you to ride waves of energy all day. It will also cause you to store belly fat. Quit drinking ALL soda and fat will melt off of you

ABOUT THE AUTHOR Matt Kirchner

Treehouse Athletic Club 801-553-0123 TacFitness.com Matt Kirchner is a Treehouse Certified Personal Trainer, and a Certified Personal Trainer (NPTI, CPT) CSCS (Certified Strength & Conditioning Specialist)

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FITNESS

WHAT’S ALL THE FUSS ABOUT YOUR

CORE? A GUIDE TO COMPLETE CORE TRAINING It should come as no surprise to us when fitness experts and physical trainers continue to harp about the importance of our core muscles. It is called our “core” for a reason.

movement and muscle efficiency, she says. They are used in everyday activities like bending over to pick up a child or twisting to see what’s behind us.

So core means abs, right? Nope. According to Lisa Matthews, a personal trainer at Treehouse Athletic Club, “The word ‘core’ generally refers to the muscles of the lumbo-pelvic region, abs, hips and lower back.” Core muscles are an essential and fundamental part of

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Starting with whole core workouts and progressing to isolated muscle groups in the core, here we provide a complete guide to core fitness.

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WHOLE CORE WORKOUT A strong core allows us to advance the rest of our body to a higher fitness level, according to Matthews. “You can train your upper and lower body to look good but you will have limitations to their progression without the support of a strong core,” she says. In addition, strengthening your whole core is a great way to prevent lower back injuries, to improve your balance, and even promote better breathing.

HOW DO YOU STRENGTHEN IT?

Traditional exercises like crunches or sit-ups are good places to start. Consider adding in workouts like a kettlebell pullover. Lie on your back with both of your knees bent to 90 degrees with the soles of your feet together. Lift a kettlebell of an appropriate weight for your skill straight above your head, holding the handle with both hands. Slowly lower the kettlebell behind you until it’s about a foot off of the ground. Hold the weight there for about 30 seconds (or as long as you can without dropping it) and bring it back above you head. That’s one repetition. Do about 5 of these and you’ll be feeling the burn in your abs and your oblique muscles, especially if you add a little twist. To target your oblique muscles and your lower back, lay on your side with your back completely straight. Crunch your legs in toward your torso without bending your legs (you’ll be raising your legs and head off the ground, not bringing your knees to your chest). At peak contraction, hold that position for 30-45 seconds (or as long as you can) and then return to rest. Do this on each side. You can do this with a weight between your feet if you want to see better results.

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THE PSOAS (PRONOUNCED SO-AZ) MUSCLE This muscle runs from the lumbar region of your spine (lower back) to the top of your femur. It’s a very important stabilizer muscle for your back and your hip flexors, which allows you to bring your knees toward your chest. Tightness or weakness in this muscle is often associated with lower back stiffness or pain, especially for those of us who sit at a desk all day. The reason for this is that, as we sit for extended periods of time, the psoas can become rounded (picture the shape of a banana); then, when we stand up, the psoas pulls on our lower back, increasing the potential for low-back pain and tightness. Furthermore, because the psoas is a stabilizer for our hip flexors, if it’s weak or shortened due to extended sitting, the hip flexors have to compensate for the psoas. This can result in pain in the knees.

HOW DO YOU STRENGTHEN IT?

The only way to strengthen the psoas is to bring your knees above 90 degrees. Sit with your back straight (posture is very important for this exercise) on a low bench or box, no more than one foot off the ground. Keeping your core tight, lift one bent knee above your hips and hold in this position for five seconds before returning to the starting position. Make sure you don’t lean forward or backward while lifting your knee. Do 3 sets of 5 repetitions with each leg. And, in a shameless plug for the next section, squats and lunges can also help strengthen this muscle.

QUADS, GLUTS, & HAMSTRINGS Some of you might be thinking, “what have my legs got to do with my core?” and you could be forgiven for doing so. Although not technically part of your core, quads and hamstring exercises will help you to strengthen all of the stabilizing muscles in your hips and lower back, not to mention you’ll have stronger, healthier legs in the process. For all intents and purposes, quads, hamstrings, and gluts should factor into your efforts for a strong core. Not only will exercising these muscles help improve your balance and athletic performance, studies show it will also produce more Human Growth Hormone (HGH) and testosterone than any other workout. HGH and testosterone are important if you’re looking to put on muscle mass, especially in the upper body, and these hormones can also help maintain muscle mass and stay lean in ageing adults.

HOW DO YOU STRENGTHEN THEM?

I hate to break it to everyone, but running or riding the stationary bike doesn’t count. Squats, deadlifts, and lunges, on the other hand, are great ways to work out all of the muscles listed above. Squats will help you build better balance and greater strength in your hip flexors and abductor muscles. You can use a squat rack at the gym or do simple body-weight squats in your living room. Both are good options for strengthening your quads, gluts and stabilizing muscles in your hips and lower back. If you really want to engage your core, do your lunges and squats on a Bosu ball. Deadlifts are another great exercise for your hamstrings and gluts. Stand with your feet shoulder width apart with a bar and weights in front of you. Squat and grab the bar, evenly spacing your hands. Stand, making sure to lift with your legs, not your back, until you’re standing up straight. Bending only at the waist and keeping your knees as straight as possible, lower the bar to the ground and bring it back up to your upright position. You should feel the burn in your gluts and your hamstrings. Complete three sets of eight to ten repetitions.

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FITNESS

Dumb Divers

5 5 Ways to Use Dumbbells Like You’ve Never Used Them Before

DUMBBELLS ARE A GREAT TOOL TO USE WHEN PERFORMING RESISTANCE TRAINING. THEY COME IN ALL SIZES, ALLOWING PEOPLE OF ALL FITNESS AND STRENGTH LEVELS TO PERFORM DIFFERENT EXERCISES. THEY ARE ALSO REALLY VERSATILE AND ALLOW YOU TO PERFORM THE STANDARD CURLS, PRESSES, ROWS, AND LUNGES THAT ARE COMMONLY SEEN IN GYMS AROUND THE COUNTRY. THE FOLLOWING 5 EXERCISES WILL INCREASE YOUR DUMBBELL REPERTOIRE.

GOBLET SQUAT

Grab a dumbbell and hold it chest height. The hands should be placed under the weighted portion of one side of the dumbbell, allowing the handle and the other weighted portion to hang between the arms. Keeping the chest up and the midsection tight, sit down and back until the hips lower below the knees. Immediately stand up. The goblet squat is a great exercise used to learn a proper squat pattern and develop strength in the quads, hamstrings, glutes, low back, abdominals, and upper back to allow a person to progress to either a back squat or front squat with a barbell. For the advanced exerciser, the goblet squat may be used to perform intervals to provide a challenging conditioning workout.

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bell 3 sity 2 4

DB SQUAT JUMP

Grab a pair of dumbbells and hold them to the side of the body. Bend the hips and knees and lower the body to a quarter squat position. Immediately, jump as high as possible.

SINGLE ARM DUMBBELL BENCH PRESS

The dumbbell squat jump is a great exercise for developing lower body power, with the best results coming from using weights up to thirty percent of oneâ&#x20AC;&#x2122;s best squat for one repetition. Reps should be kept to five or lower to ensure explosiveness.

FARMER CARRY

Grab one dumbbell and lie down on a bench. Both feet should be placed on the floor. The dumbbell should be placed to the side of the body at chest level. The free hand is placed on the hip. The exercise is performed by pressing the dumbbell until the arm is completely straight. The dumbbell is returned back to the starting position.

Grab a pair of heavy dumbbells and hold them to the side of the body, with the arms completely extended towards the ground. Keeping the torso upright and stable, walk a set distance as fast as possible and then return to the starting position without letting the dumbbells touch the ground.

The single arm dumbbell bench press is a great exercise that can be used to develop strength in the pectoral, deltoid, and tricep muscles. One added benefit this exercise provides is core stability because the abdominals must remain tight to prevent the dumbbell from pulling the exerciser off of the bench.

Even though the farmer carry is a contested strongman event, dumbbells allow the average exerciser to perform the exercise because they come in a variety of weights. Farmer carries are great for improving conditioning, burning calories, building postural strength in the upper back and abdominals, and grip strength in the forearms

BIO

WAITER WALK Grab one dumbbell and press it over head. Keeping the body square, the abdominals tight, and the shoulder stabilized, walk a specified distance. Switch hands and repeat.

ZACH GEE

Waiter Walks are great because they donâ&#x20AC;&#x2122;t require very much weight. They are great at building strength and stability in the abdominals because they prevent the dumbbell to cause the body to lean to the side during walking. Postural muscles of the shoulder and upper back are also strengthened. ADDING THESE EXERCISES WILL PROVIDE GREAT VARIETY AND HELP TAKE YOUR FITNESS TO EVEN HIGHER LEVELS.

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is the owner of Blue Collar Personal Training LLC. He is also the coach for XtremePerfect Weightlifting. Before he started Personal Training, he spent time as a graduate assistant strength and conditioning coach for Utah State University. He has a B.S. in Exercise and Sports Science and an M.Ed. in Health, Physical Education, and Recreation. He is a Certified Strength and Conditioning Specialist through the National Strength and Conditioning Association, as well as a Sports Performance Coach through USA Weightlifting.

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\ \ / /

FITNESS

THE KnowiDEFIng whatNITyou’reION striOFving forFITisNESS a good way to begin. This knowledge wil also come in handy down the road when you’re setting goals, measuring your progress, and trying to get moti>> vated again after a backslide. T is functional fitness, which takes into account your general level of health and ability to function. A healthy heart, lungs, muscles, and bones help make you functionally fit. Absence of illness and length of survival, as well as the ability to perform daily activities without noticeable discomfort or limitations, also factor into whether you are functionally fit.

here are several aspects to conditioning. One is cardiovascular fitness, which is measured by the maximum amount of oxygen your body can use (known as VO2 max). This indicates the body’s ultimate work capacity. But VO2 max cannot be measured by the average person, and it’s not all that relevant to daily life. Another aspect of conditioning that has greater relevance for most of us

FOCUS ON MODERATE ACTIVITY Today, exercise recommendations focus on moderate activity levels aimed at achieving functional fitness and avoiding disease. This differs from guidelines set out in the 1970s and 1980s that emphasized high-intensity activity directed at achieving cardiovascular fitness. This shift took place for two reasons. First, subsequent research found that lower levels of activity offered substantial health benefits. Second, public health professionals believed that focusing on activity levels that are more manageable for the average person might help motivate an increasingly sedentary population. These guidelines aren’t meant to replace the old ones. They simply offer an alternative for people who prefer less intense workouts.

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Still, achieving cardiovascular fitness can make a real-life difference, too. Even though you rarely press your heart and lungs to the utmost, the physical changes that take place as you boost your maximum exercise capacity help you perform your regular activities with less effort. Why? Because the same amount of energy output necessary to perform a task — such as walking for a given amount of time at 4 miles per hour — now demands a smaller proportion of your overall ability. Hence, work that doesn’t push you to the max feels “easier” as your fitness level improves. Your health benefits also increase when you perform greater amounts of physical activity.

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EXERCISE VS. PHYSICAL ACTIVITY

If time is a concern, try choosing i activities that are more vigorous and shortening the length of your workout. Just be sure that you don’t have any health conditions that might make vigorous activity dangerous, and gradually work up to more intense exercise.

The terms exercise and physical activity are often used interchangeably, but there are important distinctions to be made. Physical activity refers to any movement that involves muscle contractions and an increase in metabolism. This broad definition includes both aerobic and anaerobic activities. Types of physical activity are further divided into groupings based on the reasons a person performs the activity — such as transportation, recreation, or household chores.

Exercise or exercise training is technically a subcategory of physical activity. It refers to a structured program of activity for attaining physical fitness. For most people, fitness for health reasons is of greater concern than athletic performance, which demands skill, speed, and agility. The elements of health fitness include cardiorespiratory capacity, muscle strength and endurance, flexibility and balance, and weight management. A regular exercise program that incorporates all these elements is important for a healthy level of conditioning. Household activities such as sweeping or leisure pursuits like gardening can be a good way to get moving. But there’s no reason to stop there. Coupling this kind of activity with regular exercise will increase your total energy expenditure and improve your overall conditioning.

“

Runners just do it they run for the finish line even if someone else has reached it first.

”

-Author Unknown

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From the Harvard Health Publications Special Health Report, Exercise: A Program You Can Live With. Copyright 2007 by the President and Fellows of Harvard College. Illustrations by Harriet Greenfield and Michael Linkinhoker. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.

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FITNESS

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BEAUTY TIPS FROM MERRELL HOLLIS

Below are Merrell’s Top Ten Makeup Musts for achieving celebworthy skin and makeup looks.

1. USE A MAKEUP SEALANT Apply a sealant to cleansed skin before you apply a primer. This creates an invisible barrier in between the makeup and your skin while preventing perspiration or the natural oils in your skin from breaking down the primer and makeup.

2. APPLY A FACIAL PRIMER As a makeup artist and grooming expert, celebrity makeup artist Merrell Hollis has worked with some of the biggest names in music, film and fashion including Faith Evans, Naomi Campbell, Diane Von Furstenberg, Kim Cattrall, Jessica White, Joy Bryant, Mary J. Blige, Sean ‘P.Diddy’ Combs, Usher, Idris Elba and John Legend to name a few. His approach to beauty alone has made him a reputable name in the makeup industry. His creativity and eye for detail have molded the faces of many celebrities and now he’s sharing his favorite tips with the rest of us!

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Always use a primer before applying makeup. For example, instead of an eye moisturizer, use a moisturizing primer. Moisturizers can break the concealers down while a hydrating primer will give your skin the boost it needs while helping to keep the makeup on. This will cut back on the need to touch up your concealer and keep it from getting “cakey”.

3. LEARN THE COLOR WHEEL

Knowing which colors compliment each other will make picking out the right makeup shades a cinch!

4. USE A FAN BRUSH TO APPLY BLUSH Thanks to the super long bristles, a fan brush softly deposits the color on the cheeks with a more natural look.

5. EYEBROW TIPS

When shaping in your eyebrows, don’t over pluck in the pursuit of perfection. Just remember - they are sisters not twins.

6. TO MASK DISCOLORATION AND UNEVEN TONE AROUND THE MOUTH

Use an orange or peach pigment to brighten up the appearance of the skin. It enhances the skin and stops it from looking ashy around the mouth.

7. USE YOUR FINGERS ON DELICATE SKIN

Set under eye makeup using a translucent powder and your fingertips - not a sponge or makeup brush which can leave lines and creases.

8. USE THE RIGHT TOOLS When applying foundation, opt for a beauty sponge instead of a brush. Brushes are great but can remove a lot of the makeup. Instead, gently press makeup into the skin using a sponge – this will give the canvas a soft, airbrushed looked.

9. APPLY YOUR EYE MAKEUP LAST

After you have finished with foundation, concealer and bronzer, apply your eye make up. It makes it easier to see where to go once the face is contoured.

10. CHOOSING THE RIGHT FOUNDATION COLOR

The right foundation color will match your face, ears, neck, chest and hairline. To customize your over-thecounter foundation by season, add in a white color pigment to lighten it for spring/summer months or black pigment to deepen the tone for fall/winter.

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Cadbury is making a chocolate that won’t turn to liquid even in temperatures over 100 degrees.

CHOCOLATE MONEY

Chocolate is an $83 billion a year business. That is more than the GDP for 130 nations on earth. Scientific American estimates that there are about 5-6 million cocoa farmers around the world. Source: MarketsandMarkets

Chocolate News / (Finally Some News We Care About)

CHOCOLATE THAT DOESN’T MELT

DARK CHOCOLATE DEMAND

In recent years the demand for dark chocolate is growing around the world. It now represents a fifth of the American demand for chocolate.

For the latest in news and research go to

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OUR CHOCOLATE COMPETITION Brazilians are all of a sudden crazy about chocolate. Per capita chocolate consumption there is growing three times faster than in the US, according to Max Rangel, senior VP of global chocolate at Hershey Co. Producers can’t keep up with demand.

CocoaTrees:Bizarre Cocoa seed pods grow directly onto the trunk of the tree, and not on branches. Each pod is about the size of a pineapple, and holds 30-50 cocoa seeds. That is enough to make about 7 milk chocolate and 2 dark chocolate bars.

75% “Strength is the capacity to break a chocolate bar into four pieces with your bare hands - and then eat just one of the pieces.”

GOD BLESS THE RAINS DOWN IN AFRICA Africa produces more than 75 percent of the world’s cocoa, but only consumes about 3 percent of it.

-Judith Viorst

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>> Advisor Diabetes

Diabetes, The Sneaky Disease THAT MUST BE STOPPED QUESTION: What do you get when you combine pre-diabetes, type 1, and type 2 diabetes? ANSWER: Three powerhouse organizations (and three fantastically passionate women) dedicated to raising diabetes awareness, helping those in the community impacted by this disease, and finding a cure for an illness that affects approximately 235,000 people in the great Beehive State. Laura Western, executive director, JDRF; Beverly Bartel, manager of mission delivery, American Diabetes Association (ADA); and Brenda Ralls, epidemiologist, Healthy Living through Environment, Policy and Improved Clinical Care Program (EPICC), The Department of Health, are collaborating for November National Diabetes Month and holding a press conference on World Diabetes Day, November 14, to address the public on this pandemic. “Many of our young people struggle with obesity and sedentary lifestyles, putting them at risk for developing pre-diabetes,” said Brenda Ralls. “With pre-diabetes, blood sugars are elevated but not high enough to meet the threshold for a diabetes diagnosis. Pre-diabetes usually precedes type 2 but can be prevented or delayed through simple lifestyle changes.” While type 2 individuals make insulin, their body cannot use it properly. But by eating healthier, increasing physical activity, and losing weight, people can achieve normal body function again. With type 1 (T1D), individuals do not make any insulin – their pancreas has stopped working and they must manually give themselves insulin to live.

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“I see firsthand the challenges of T1D for local families who live every day with this difficult disease,” said Laura Western. “With November being Diabetes Awareness Month, we are partnering with two powerful organizations to bring awareness and attention to this disease. It’s important for the community to know its propensity so we may rally to find a cure.” Beverly Bartel wants you to know that “Diabetes doesn’t stop… ever! It’s a 24/7, 365- days-a-year disease. It takes extraordinary effort to live with this, day after day, week after week, month after month, year after year.” WHAT THEY ALL WANT YOU TO KNOW: Diabetes is a sneaky disease that claims lives and robs health. Don't wait. Ask your doctor for a diabetes screening today! • More than 135,000 local adults (about 6.9%) have been diagnosed with diabetes, and approximately 100,000 with pre-diabetes. • If not well controlled, diabetes can lead to serious complications, including blindness, amputation, cardiovascular disease and kidney failure. • In many cases, progression from prediabetes to type 2 can be prevented or delayed through simple lifestyle changes. • If you are a Pacific Islander, Hispanic, Native American, Asian or African American, you are at a much higher risk. Laura concludes “I dedicate this month

to every Mom and Dad with a T1D child, to every doctor who holds the hand of a newly diagnosed, to every person affected by diabetes, and to every researcher with a laser focus on solving this problem. We are forever grateful for your dedication, passion, and commitment to find a cure.”

ABOUT THE AUTHOR Aimee Greenholtz JDRF - Juvenile Diabetes Research Foundation jdrf.org

Aimee is a content editor for healthfuldiabetes.com, affordablediabetes.com and dollardiabetesclub.com. Having this disease for more than 20 years and being a pastry chef, Ms. Greenholtz knows the importance of living healthfully and enjoying life. She can be reached at agreenholtz@keyvive.com.

(from left to right) Beverly Bartel, ADA, Brenda Ralls, UDOH, and Laura Western, JDRF join forces to bring diabetes awareness during National Diabetes Month in November.

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7th

371million

leading cause of death in the United States.

Diabetes affects: • 25.8 million people in the US, 371 million globally. • 8.3 percent of the US population (diagnosed:18.8 million, undiagnosed: 7 million)

Half of people with diabetes worldwide don’t know they have it.

2012:

4.8 million

people died worldwide due to diabetes. Source: IDF

Source: International Diabetes Federation (IDF)

Diabetes at a Glance

It is the

THE AMERICAN DIABETES ASSOCIATION (ADA) released

new dietary guidelines for diabetic individuals, including new regulations for sugary drinks and sodium consumption. The ADA says diabetic patients should choose nutrient-dense, high-fiber foods, and should avoid processed foods with added sodium, fat and sugars, which isn’t all that different from dietary recommendations for the general population.

NEW TO THE ADA

WHAT DAMAGE DOES DIABETES CAUSE? • Diabetes is the leading cause of new cases of blindness among adults aged 20-74. • Diabetes is the leading cause of kidney failure. • About 60% to 70 % of people with diabetes have mild to severe forms of nervous system damage. This can mean impaired sensation or pain in the feet or hands, slowed digestion of food, carpal tunnel syndrome and more. • More than 60% of nontraumatic lower-limb amputations occur in people with diabetes. In 2006, there were nearly 66,000 such amputations performed in diabetic patients in the United States. • Diabetic adults are twice as likely to have periodontal gum disease than those without diabetes. • Diabetic individuals are twice as likely to have depression.

recommendations is a warning against sugar-sweetened beverages. Also, the previous recommended limit of 2000 mg/day of sodium for diabetic patients is raised to 2300 mg/day, which is the same as the general population. Research, the ADA says, doesn’t support a lower sodium consumption for these patients. The new guidelines also advise patients against using vitamin or mineral supplements, or herbs. Furthermore, the document states, omega-3 supplements aren’t proven to prevent cardiovascular disease in people with diabetes. It is hoped that a nutritional focus for treating diabetes will receive the priority it deserves. Diet is a crucial factor in dealing with diabetes.

NOTABLE PEOPLE WHO HAVE DIABETES

Tom Hanks, actor Halle Berry, actress Jay Cutler, NFL quarterback Brad Wilk, drummer, Rage Against the Machine Sonia Sotomayor, Supreme Court Justice Nick Jonas, singer, Jonas Brothers

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THE HEALTHY HOLIDAY ISSUE 2018

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National nutrition experts say we shouldnâ&#x20AC;&#x2122;t consume more than 2,300 milligrams of sodium a day, which is less than a teaspoon of salt.

contraction of muscle fibers and the transmission of nerve impulses. But the body only needs a small amount of sodium to effectively perform these tasks. When there is an excess, the kidneys start having trouble handling it. The body responds by holding water to dilute the sodium, which increases both the amount of fluid surrounding cells and the volume of blood in the bloodstream. This means the heart must work harder and the blood vessels feel more pressure, which increases the likelihood of high blood pressure, heart attack and stroke.

Some say it is better to consume even less than this. The American Heart Association says 1500 milligrams is the mark to shoot for, though the Institute of Medicine says there may be no benefit to going this low. In fact, it may cause harm, they say. After all, sodium is an important electrolyte, maintaining proper fluid balance in and around cells, according to the Harvard School of Public Health. Sodium is also important for the

PIZZA

One slice, with common toppings, can destroy your sodium intake goals.

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On average, Americans eat about 3,400 milligrams a day, which is significantly more than is needed.

SOUP

Some canned soups contain almost 1000 milligrams of sodium. Read the label.

SANDWICH

Just one sandwich can exceed daily recommendations for salt intake. Bread, cheese and deli meats combine to pack a salty punch.

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A Salt For Every Occasion

Salt is an important part of our diet. It provides us with a good source of iodine and it’s an extremely important electrolyte for our brains. If you’re anything like me, though, you had probably heard of kosher salt but weren’t exactly sure how it differed from regular table salt. Here’s a simple guide to a few kinds of useful salts and some you might not have known even existed!

Kosher Salt

This salt is so named because of its usefulness in curing meats. Kosher dietary laws strictly require that as much blood as possible be drawn from the meat before cooking. Kosher salt has done the job well for centuries now. This salt is unrefined and has a coarser grain along with a larger crystal structure. This salt is a favorite of chefs because of its superior texture and brighter flavor. Be warned, this salt won’t taste as salty as your table salt, so adjust your recipes accordingly.

Sea Salt

At one time thought to be healthier than regular table salt because of its trace minerals, sea salt is another variety of salt with which to flavor your favorite dish. Sea salt comes in both fine and coarse grains, meaning it can be used for a number of different purposes. Sea salt does have a slightly different taste depending on where it is derived. Try out a few different kinds until you find the one you like. This kind of salt will be best used when sprinkling over freshly prepared hot food, shortly before serving.

Celtic Salt

This one is for the connoisseurs out there. Celtic salt is harvested via a 2,000-year-old method of solar evaporation from the waters of the Celtic Sea marshes in Brittany, France. Experts describe its flavor as a mellow saltiness with a touch of sweetness. And if you’re feeling really fancy, try fleur de sel, an extremely rare kind of salt from marshes in Guerande, France. This salt is said to form only when the wind blows from the east and if the other conditions are just right.

Pickling Salt

Salt has long been used to preserve meats and other foods. This is a very finegrained salt that is used in cure dairy products, canning, and pickling. It has no additives like iodine or anti-caking agents, which can cloud your brine or leave sediment at the bottom of your jar. Because the grain is so fine, it quickly dissolves in water, making it perfect for use in brines.

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They lie about smoking, diet, exercise, adherence to medication, sexual activity and more, for a number of reasons:

gg Desire to minimize/avoid treatment. gg Desire to get treatment/medications. gg Fear of monetary costs. gg Desire to avoid conflict/have doctor be pleased. gg Embarrassment. Sometimes medical histories can include some embarrassing, even shameful things. gg Nervousness gg Provider seems rushed, patient doesn’t want to be a burden.

Doctor,

My Nose

Keeps

Growing

Longer

& Longer WHY WE LIE TO PEOPLE WEARING STETHOSCOPES

WRITTEN BY MICHAEL RICHARDSON

How often do you exercise?” the doctor asks. “About 3 times a week,” the patient responds, ignoring the little voice in the back of his head. It’s probably more like once a week, when he really thinks about it. But at least he avoided a lecture, right? Sure he may’ve avoided a lecture. Lying to the doctor is also a great way to avoid good health care. Business people make decisions based on accurate numbers, pilots take off with a plan based on quality weather reports and firemen respond to fires based on 911 calls. Good communication is crucial to excellence in whatever endeavor you undertake, and health is no different. Yet Americans lie to doctors. Surveys from the Cleveland Clinic and WebMD show that millions of Americans either blatantly lie or distort the truth to their doctors, effectively saying, “let me make it harder for you to help me.”

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All these reasons to lie are understandable. But the consequences can be serious. Say a man lies about taking his blood pressure medication. The doctor thinks the medication isn’t working, and so he changes the medication, or ups the dosage. Now the man’s health is in jeopardy when he does decide to take the medication. Perhaps we lie because we fear confrontation with the doctor, a confrontation that in reality might be nothing more than a conversation. Lies often come because we wrongly estimate a doctor’s response. "We aren't here to render moral judgments," says cardiologist Dr. Amy Tucker, associate professor of internal medicine at the University of Virginia Health System, to thedailybeast.com. "So the half-truths really aren't necessary." But doctors still expect half-truths. Dr. Don Bigelow, a Salt Lake City dentist, says that many patients are embarrassed that they aren’t faithful to their good habits, and fear a lecture. So he fights lies by not giving lectures. “I think it eases their mind,” he says. “We can tell if they have been brushing and flossing on a regular basis just through the examination, so we don’t need to harp on them about it. In my office our gentle reminder comes by way of giving them a new toothbrush and some floss when they leave the office...enough said right there.” But, Dr. Bigelow adds, lying about changes in medication, medical history, or illegal drug use is on a different level than lying about flossing. Patient health and safety is of paramount importance, he says, and more serious lies can compromise this safety.

THE SYSTEM MADE ME DO IT

Patient lies only explain part of the problem, according to John Palmieri, MD, of Massachusetts General Hospital and author of an article exploring lies in doctor-patient relationships. A typical seven minute doctor visit, he says, isn’t long enough for complete openness. “Full disclosure of truth is generally not possible in most situations,” he says. “Some items will be glossed over, or ignored altogether. Such omissions compromise the exchange, aside from the more blatant misrepresentations.” He says the important question that needs answering today is how to create an environment that maximizes openness. However, don’t let the excuse “I ran out of time” keep you from mentioning a symptom to your doctor, or from answering questions fully. In the end, we should be fighting for the doctor’s understanding, not attempting to cloud it.

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WHY YOU SHOULDN’T LIE TO THE DOCTOR gg Once a doctor knows you’ve lied (and remember the doctor is probably adept at recognizing lies), he must account for the possibility of future lies. Care can’t be as exact, and the relationship with your doctor, which is important, suffers. gg Lying to your doctor can lead to seriously damaging medication combinations. Say you lie about taking a certain supplement, because you’re embarrassed about taking it. The doctor may prescribe a medication that causes harm when combined with that supplement. gg You waste money. The doctor is trying to monitor your health, and you are projecting a false image. It’s like wearing gloves during a visit to a palm-reader. gg You might end up getting unnecessary treatment. This can both lead to sideeffects and more wasted money. gg You might develop a preventable disease or health condition.

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Health Gaffes People Make Without a Clue

From gluten to weightlifting to Tylenol, you might be headed for a bewildered demise WRITTEN BY TAYLOR SMITH

THERE COME TIMES IN ALL OUR LIVES WHEN WE MUST TAKE AN INVENTORY OF OUR HABITS. Making that mental,

or sometimes literal, list of things we need to improve upon is an important part of living a healthy lifestyle. Whether it’s our workout routine, our eating habits, or more generally our lifestyle, we sometimes do unhealthy things without fully considering the ramifications, or because we actually think they’re beneficial. The following are six myths that might reveal a disparity between what you believe and what is actually true.

NUTRITION MYTHS

1 “GLUTEN IS THE DEVIL IN DISGUISE”

2 “SUGAR IS THE DEVIL IN DISGUISE”

Gluten has taken quite the bad rap lately. It’s not all for nothing, especially as we learn more about Celiac disease. Many people are cutting gluten out of their diet and claiming they feel better than ever, and even though I’m not one to burst anyone’s bubble (especially when it comes to trying to live a healthy lifestyle), there are some risks in needlessly cutting gluten out of your diet.

I could say, “return to point 1” and that would almost be enough. There are, however, a few things that need to be said about sugar. First of all, I’m not trying to redeem the health value of sugar because that wouldn’t end well for me. On the contrary, I’m simply trying to make a larger point about nutrition—it’s all about balance and moderation. We might (and probably do) consume too much sugar. But cutting sugar out of our diet entirely to reach our nutrition goals might not be necessary. Calories from sugar are no different than calories from fats and proteins. When it comes to weight loss or good nutrition it doesn’t have to be a miserable journey of self-denial, a veritable life in the wilderness living off of vegetables and little else. In the end it’s all about calorie input vs. calorie output. If you can watch how much you snack and try to limit the treats, your weight loss and general nutrition goals are still very achievable. Simply put, sugar can have a place in a healthy diet, as long as it’s in moderation.

“The major risk is that by cutting out gluten you’re also depriving yourself of a primary source of folate, which can lead to an increased risk of heart attack and pre-natal problems for pregnant mothers. Additionally, folate deficiencies can result in weakness, loss of appetite, headaches, heart palpitations, or even anemia.”

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FITNESS MYTHS

“NO PAIN, NO GAIN” It sounds simple enough, but talk to a fitness expert or personal trainer and they’ll tell you that the jury might still be out on this one. Let’s remember, though, that, as in all things, determining what the word pain means is very important. Pain shouldn’t equal injury, ever. Muscle burn? That’s a different story. Herein lies the confusion. I think just about every fitness expert is going to say they’re simply trying to push people to their limits in order to make progress. They definitely don’t mean that you should keep working out until you injure yourself. Moreover, many wrongfully assume that unless you’re sore the next day, your workout was a waste. It’s true, Delayed Onset Muscle Soreness (DOMS) is a good indication that you fatigued your muscles, and if you’re trying to bulk up, it might be what you’re shooting for. It is not, however, the only indication of progress in terms of building strength and endurance. It’s all about working smarter, not harder.

“LIFTING WEIGHTS WILL MAKE WOMEN

BULKY” Rest assured ladies, looking like a body builder doesn’t happen overnight. Yet many women still avoid starting a weight lifting regimen because they’re worried they might end up looking like the “Govenator” circa 1980.

“The reality is that women don’t have enough testosterone to get bulky and build extra large muscles. Plus, if you’re skipping the weights, you’re not only missing out on a rewarding workout, you’re also missing out on some great health benefits.” Weight lifting is great for toning your muscles, not to mention it helps strengthen your bones and give you more energy for the demands of your day.

LIFESTYLE MYTHS

5 “TANNING BOOTHS ARE SAFE…AS LONG AS THEY DON’T HAVE UVB RAYS”

We often associate a tan with a “healthy glow,” but there is nothing even remotely healthy about tanning, even if it’s done with UVA rays. In fact, tanning is an almost sure fire way to get cancer. The World Health Organization just moved tanning beds to its list of cancer-causing items. And according to Dr. Celeste Robb-Nicholson, Editor in Chief of Harvard Women’s Health Watch, if you regularly “fake-bake” you are 50 to 100 percent more likely to get skin cancer than those who don’t. Not convinced? Consider this:

“The Skin Cancer Foundation reports that you are 15 percent more likely to develop a melanoma if you have ever used a tanning bed, with that number elevating to 75 percent when the first use is before the age of 35.”

6 “'USE ONLY AS DIRECTED' DOESN’T APPLY TO OTC MEDS” “Federal data also shows that as many as 78,000 Americans are sent to the ER annually with 33,000 of those resulting in hospitalization, all because of acetaminophen overdoses.

Drugs like Tylenol and Ibuprofen are known for being safe painkillers and fever-reducers. Many of us think that if we take it often, we can take more than the recommended dose with no ill effects. What you might not know is that during the last decade more than 1,500 Americans have accidentally and fatally overdosed on Tylenol. Painkillers like Tylenol and ibuprofen are safe drugs—as long as they’re used only as directed and when taken in the proper doses. It’s very important to remember that any over-the-counter drug can cause damage to the stomach and other vital organs if taken in excess. Taking aspirin or ibuprofen, even at their recommended dosages, can lead to stomach bleeding. According to the FDA “taken over several days, as little as 25 percent above the maximum dose—or just two additional extrastrength pills—has been reported to cause liver damage.”

(Source: propublica.org)”

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THE HEALTHY HOLIDAY ISSUE 2018

WRITTEN BY TAYLOR SMITH

n 1969, we put a man on the moon, with the help of some tremendous computing power that occupied multiple rooms. Today, the same computing power sits in your smart phone, which provides almost limitless information and entertainment at blinding speeds through the Internet. With this incredible power at our fingertips, and with the number of internet users approaching 3 billion, it’s no wonder that researchers and scientists have taken notice of some of the effects that the spread of the Internet has had on mental and physical health. The Internet is everywhere—Wi-Fi hotspots dot the landscape and most people carry high speed Internet around with them in their pockets. It’s strange to think how much things have changed in only a decade. Ten years ago, you were lucky to have broadband Internet in your home. According to internetworldstats. com, in December of 2003, there were 719 million users accessing the Internet. Over that ten-year period, the number of Internet users has risen to 2,749 billions. That’s a truly astonishing number. The Internet is now available to billions

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of people and that number will only continue to increase. And these changes are not without consequence. In the fifth, and most recent publication of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-V, the American Psychiatry Association (APA) has listed “Internet Gaming Disorder” as “a condition warranting more clinical research and experience.” Internet gaming is a relatively recent phenomenon that directly coincides with the continued spread and increase in access to the Internet. Online gaming, in extreme cases, oftentimes leads to the exclusion of sociality, workplace responsibilities, and academic performance, to name only a few consequences. “Gamers” sometimes neglect more pressing concerns in the real world in order to spend hours upon hours living out virtual lives in fantasy realms. The negative effects are not only social in nature however. Recently, PBS aired a compelling segment entitled “Digital_ Nation: Life on the virtual frontier,” on its flagship program Frontline. In this

segment, reporters presented many different aspects of our rapidly changing world and the role that technology, and particularly the Internet, are having in that change. The program discusses everything from change in everyday relationships between individuals to the more far-reaching effects of the proliferation of the Internet on the global economy. The program also focuses on the effects of Internet addiction and compulsive Internet gaming. A young Korean man details the negative health effects of compulsive gaming including: poor and worsening eyesight, numerous cavities, disruption of normal sleeping patterns, and physical weakness from lack of exercise. He goes on to say that many of his

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APA has cited reports that suggest “gamers” are neurologically stimulated by game play in the same way that certain chemical substances and drugs stimulate addicts. Likewise, “gamers” have also been observed to exhibit the symptoms of withdrawal when the option to play has been taken away. Now, some of you might be asking, “where are the parents,” and you’re right to do so. Some of you might be saying, “video games aren’t the problem,” and you’d be right again. Surely, video games can be an entertaining and perfectly healthy activity—when done in moderation. Just like anything that is exciting or fun, in excess it can become detrimental to our lives and even resemble addiction. So, what are the treatment options for someone who might suffer from “Internet Gaming Disorder”? If you are a parent who fears your child might fall into that category: gg Open up a dialogue. Talk to your children and demonstrate your concern. gg Seek professional help. If things are really bad enough and you or someone you love can’t stop playing video games, there are professionals, psychiatrists and therapists who can help.

Internet users, 2013: 2,749,000,000 Facebook.com/HealthyMag

ailments have resulted from a distinct lack of concern for his own physical hygiene and living a sedentary life. His grades in school suffer as well, because, as he describes, when he is in school, all he can think about is getting home to play video games. The APA included “Internet Gaming Disorder” in the DSM-V largely to raise awareness of an increasingly common situation. The preoccupation that “gamers” develop for their video games comes at a costly price. Games can monopolize young people’s lives to the detriment of their physical and mental development. If unchecked, it can become a full-blown addiction. The

gg Take preventative measures. If you’re a parent of a child who spends a lot of time playing video games, place limits on the amount of time they can play. Encourage them to spend time outside, engaging in physical activity. If that doesn’t interest them, find something that does. As in all things, self-control is vitally important to mental and physical health. Likewise, prevention is always easier than the cure. And that’s just food for thought.

For further information on teens and addiction, you can visit phsychiatry.org or healthyminds.org.

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recipes

Recipes the whole family will enjoy

food

Transform your favorite meals into diet-friendly treats

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>> Advisor Allergies

Allergy-Free Holidays STUFFED WITH ALLERGY, & ASTHMA TRIGGERS TIPS FOR A MISERY-FREE HOLIDAY The holidays are about family, food and travel. And for the millions of Americans with allergies or asthma, it’s about navigating a minefield of triggers, from the pumpkin pie to the dusty guest bedroom. A number of holidayrelated triggers can make people sneeze, wheeze or, in the case of food allergies, have a more serious reaction. But by planning ahead, the day can be misery-free.

•

The American College of Allergy, Asthma and Immunology have several suggestions to help those with food allergies, environmental allergies or asthma avoid unnecessary suffering.

•

For guests with food allergies, the holiday feast often includes common food allergens such as wheat, eggs, soy, dairy, peanuts, and nuts:

•

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•

NOW FOR DESSERT – Even

though pumpkin allergies are rare, America’s favorite Thanksgiving pie can cause problems. Be sure to offer alternative desserts. To be on the safe side, suggest guests with serious food allergies bring their own sweet treats.

WATCH OUT FOR ENVIRONMENTAL TRIGGERS, AS WELL:

TALKING TURKEY –

The centerpiece of the Thanksgiving meal may seem safe, but self-basting turkeys can include soy, wheat and dairy. A natural turkey is your best bet since by law it must contain nothing but turkey and water. Also, be sure the stuffing is made from wheatfree bread.

ON THE SIDE – For allergen-free mashed potatoes, swap the milk and butter for chicken broth and margarine. Use corn-starch to thicken the gravy instead of wheat flour. And forget about topping the green bean casserole with slivered almonds.

WASH-UP WOES – Aunt Sophie’s fancy guest soap may contain fragrance that can cause allergic contact dermatitis. Use the regular soap or bring your own.

•

PROBLEM PETS – If you’re allergic to furry animals, asking grandma to lock her cat in the basement during your visit will do little if anything to ease your misery. That’s because pet dander gets everywhere and is difficult to eradicate. However, you can help yourself by taking symptom-easing medications prior to your visit. I am happy to recommend treatments for your pet allergy, such as antihistamines, nasal sprays, or appropriate asthma medications. NO REST FOR THE ALLERGIC – Dust mites

are one of the most common allergy and asthma triggers. To prevent your allergic guests from sneezing all night long, thoroughly dust the extra bedroom and wash bedding in hot water. If you have allergies and are doing the visiting, pack your own pillow or allergen-proof pillow cover.

ABOUT THE AUTHOR Douglas H. Jones, MD Rocky Mountain Allergy, Asthma & Immunology rockymountainallergy.com Dr. Jones specializes in the diagnosis and treatment of all conditions relating to allergies, asthma and immune system disorders. He is board certified by the American Board of Allergy and Immunology and the American Board of Internal Medicine. He earned his MD from Penn State University and completed his specialty training at Creighton University.

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recipes

Ingredients

4 soft corn tortillas, cut into 1-by-2-inch strips 1 tablespoon extra-virgin olive oil 1 pound boneless, skinless chicken breast, trimmed of fat and diced 3 cups frozen bell pepper and onion mix (about 10 ounces) 1 tablespoon ground cumin 2 14-ounce cans reduced-sodium chicken broth 1 15-ounce can diced tomatoes, preferably with green chiles 1/4 teaspoon freshly ground pepper 2 tablespoons lime juice 1/2 cup chopped fresh cilantro 3/4 cup shredded reduced-fat Cheddar or Monterey Jack cheese

Directions

1. Preheat oven to 350Â°F. Spread tortillas in a

single layer on a baking sheet. Bake until lightly browned and crisp, 10 to 12 minutes. 2. Meanwhile, heat oil in a Dutch oven over

medium-high heat. Add chicken and cook, stirring occasionally, until beginning to brown, 3 to 4 minutes. Transfer to a plate using a slotted spoon. Add pepper-onion mix and cumin to the pot. Cook, stirring occasionally, until the onions are lightly browned, about 4 minutes. Add broth, tomatoes, pepper and lime juice; bring to a simmer and cook, stirring often, until the vegetables are tender, about 3 minutes more. Return the chicken and any accumulated juice to the pot and cook, stirring, until heated through, about 1 minute. Remove from the heat; stir in cilantro. Serve topped with the toasted tortilla strips and cheese.

Chicken Tortilla Soup [ 1 1/3 CUPS EACH ]

serves 4

Making soups may have once been an all-day affair, but hereâ&#x20AC;&#x2122;s a great example of how a few choice convenience products can renovate an old favorite for our modern, hectic lives. Some frozen vegetables, a few canned tomatoes and canned broth--and voila! a Tex-Mex favorite in minutes.

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Nutrition Information:

Per serving: 357 calories; 12 g fat (5 g sat, 4 g mono); 87 mg cholesterol; 24 g carbohydrate; 37 g protein; 4 g fiber; 603 mg sodium. Source: www.eatingwell.com

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recipes

©Jessieeldora | Dreamstime.com

Soupe à l’Oignon Gratinée

[ ON I ON SOU P ] serves 6

Onions always make me thinkof Alsace-Lorraine. So, perhaps a Riesling from there will do the trick here, or a Crémant d’Alsace whose bubbles will help cut through the richness of the cheese and sweetness of the Ingredients

6 tbsp unsalted butter 8 cups cold Beef Stock 81/2 cups sweet onions, thinly sliced Salt and pepper as needed 4 garlic cloves, minced Cayenne pepper as needed 2 tsp curry powder 1 2 toasted baguette slices, 1/4-inch thick 11/2 cups Chablis 3 cups grated Gruyère cheese 2 tbsp all-purpose flour 1 tsp chopped parsley

Directions

1. Preheat the oven to 450°F. 2. Heat the butter on medium heat in a large, thick-

bottomed pan. Add the onions and sauté until they’re softened and a light caramel color, 20 to 25 minutes. 3. Add the garlic and curry powder and continue to cook

for another 2 minutes, until the spices release their oils and subsequent aroma. Add the Chablis and reduce until the wine is cooked dry, 18 to 20 minutes. Add the flour and cook for 2 more minutes.

4. Take the pan off the heat and pour in the cold stock,

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stirring thoroughly to distribute the flour throughout the soup. Return the pan to the heat and bring to a boil; reduce the heat to low and simmer for 30 minutes. 5. Season the soup as needed with salt, black pepper, and

cayenne pepper. Ladle the soup into oven-safe bowls, and top with slices of toasted baguette covered with plenty of Gruyère. Place the soup into the oven or under a broiler and cook until it’s golden brown and bubbly, about 10 minutes. 6. Sprinkle each bowl of soup with parsley and serve

it immediately.

Bistros and Brasseries: Recipes and Reflections on Classic Cafe cooking, from The Culinary Institute of America

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Photo credit: Colin Erricson/www.robertrose.ca

Cranberry Creations

Cranberry Maple Squares Makes 24 squares

Enjoy a deliciously wonderful treat for the whole family this holiday, or any day of the week! Flat beater Wire whip Preheat oven to 350°F (180°C) 13- by 9-inch (3 L) metal baking pan, greased and lined with greased parchment paper 2 cups unbleached all-purpose flour 1⁄4 cup granulated sugar 2⁄3 cup cold unsalted butter, cut into small pieces 1 tsp baking powder 1⁄4 tsp salt 2 eggs Filling 3⁄4 cup lightly packed light brown sugar 1⁄2 cup unsalted butter, softened 1⁄4 cup pure maple syrup 4 eggs 11⁄4 cups pecan halves, chopped 11⁄2 cups dried cranberries Pinch of salt

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Place flour, sugar, butter, baking powder and salt in the mixer bowl. Attach the flat beater and mixer bowl to the mixer. Set to Speed 2 and beat until mixture resembles coarse crumbs. Beat in eggs, one at a time, until dough forms a ball. On a floured work surface, roll out dough into a 13- by 9-inch (33 by 23 cm) rectangle. Carefully fold twice so it is easier to transfer to the prepared pan. Unfold into the pan, pressing evenly into the bottom and 1 inch (2.5 cm) up the sides. Refrigerate while you prepare the filling. Prepare the filling: Place brown sugar and butter in clean mixer bowl. Remove the flat beater and attach the whip and mixer bowl to the mixer. Set to Speed 4 and beat until light and fluffy. Beat in maple syrup. Beat in eggs, one at a time, until smooth. Remove the mixer bowl. Using a rubber spatula, stir in pecans, cranberries and salt until evenly incorporated. Pour filling into dough and spread evenly in the pan. Bake in lower third of preheated oven for 35 to 40 minutes, or until pastry is golden and filling is set. Let cool completely in pan on a wire rack. Cut into squares.

Make ahead Store in an airtight container at room temperature for up to 3 days or in the freezer for up to 4 weeks.

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Pink Chantilly with Cranberries Photo credit: Colin Erricson/www.robertrose.ca

Makes 4 servings

Filled with antioxidants and loaded with vitamin C, cranberries are very healthful. However, we hear so much about their health benefits that we sometimes forget how truly delicious they can be. This recipe is certainly the simplest and one of the most beautiful ways to serve cranberries. Four 8-ounce (250 mL) tall jars Blender Fine-mesh sieve Electric mixer 11⁄2 cups raspberries, fresh or frozen 3 tbsp confectioner’s (icing) sugar 2 cups frozen cranberries, thawed 1⁄2 cup maple syrup (see Tips) 11⁄2 cups heavy or whipping (35%) cream 1 tbsp granulated sugar 1 tsp vanilla extract 1⁄2 cup cranberry juice Mint leaves 1. 2. 3. 4. 5.

In blender, purée raspberries and confectioner’s sugar. Transfer to a fine-mesh sieve placed over a bowl and press mixture through. Discard seeds and set raspberry purée aside. In a saucepan over medium heat, cook cranberries and maple syrup, stirring often, for 15 minutes. Remove from heat and set aside to cool. In a large bowl, using electric mixer at high speed, whip cream, granulated sugar and vanilla until soft peaks begin to form. Beating constantly, slowly add cranberry juice and half the raspberry purée. Spoon remaining raspberry purée into jars, dividing equally. Top with whipped cream mixture, dividing equally. Refrigerate for up to 30 minutes. When you’re ready to serve, remove jars from refrigerator and top with cooked cranberries. Using a long spoon, mix delicately. Garnish with mint leaves and serve immediately.

Tips Make sure to use real maple syrup. Maple-flavored and other table syrups contain a lot of granulated sugar or corn syrup and do not cook the same way. It’s worth every penny to get the real thing. Excerpted from The Complete Best of Bridge Cookbooks, Volume 3 by The Best of Bridge Ladies © 2013 www. robertrose.ca Reprinted with publisher permission.

Cranberry Scones Makes 8 large scones.

Photo credit: Colin Erricson/www.robertrose.ca

Perfect for holiday snacks and entertaining!

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3⁄4 cup buttermilk or plain yogurt 1 large egg 2 3⁄4 cups all-purpose flour 4 tsp baking powder 1⁄2 tsp baking soda 1⁄2 tsp salt 1⁄2 cup margarine 1 cup coarsely chopped cranberries (fresh or frozen) 1⁄2 cup granulated sugar Grated zest of 1 orange 1 tbsp butter, melted 1⁄4 cup confectioners’ (icing) sugar Preheat oven to 375°F (190°C). Beat buttermilk and egg in small bowl and set aside. In large bowl, Combine flour, baking powder, baking soda and salt. Cut in margarine until mixture resembles small peas. Mix in cranberries, sugar and orange zest. Add buttermilk mixture and stir until soft dough forms. Using your hands, form dough into a large ball and place on floured surface. Pat out to 1-inch (2.5 cm) thickness. Cut in 4-inch (20 cm) rounds. Place on ungreased cookie sheet and bake scones for 15 to 20 minutes. While still warm, brush with butter and sprinkle with confectioners’ sugar.

THE HEALTHY HOLIDAY ISSUE 2018

BOOK OF LIFE

Cheat Sheet “Doing what you love” shouldn’t be your expectation, it should be thought of as a privilege that requires a lot of work.

The easy road is actually the more difficult one.

Cutting corners to avoid effort and discomfort is a sure way to find yourself in a pile of regret one day. Jobs, relationships, fitness, they just won’t be where you want them to be.

Some people mistakenly think that their dreams will end up coming to fruition, regardless of how much work they put in.

Success is built brick by brick, not all at once.

Enjoying the journey is a learned skill. Happiness isn’t always automatic, but you can help it come more often. Some people learn this skill more easily than others. Recognize that you can find joy in hard times, in struggle and in success.

You don’t really become good at something unless you do it every day for a long time, and fail at it constantly. Most successful people have found a way to build successful habits; only a few get a lucky roll of the dice.

Let love simmer.

Acting rashly in passionate feelings for another is often a mistake. Take a step back, and let your relationship find root.

You’re never the best version of yourself. Find contentment in your accomplishments, but don’t ever stop growing.

Flaunting personal achievement is to reveal vulnerability.

You can generally tell if someone has found fulfillment in what they do, or if they have to prop themselves up on their past achievements to feel good.

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Life Lessons To Learn Now, Not Later

Don’t waste time trying to fix other people’s flaws. Focus on your own.

Our instinct is to see flaws in others and think of all the ways they could improve. It just isn’t a worthwhile way to think.

Most are self-interested, but great rewards await those who are selfless. We often get offended when we realize that other people really care about themselves first and foremost. But this is human nature. Ascending above human nature bears fruit.

The people around you influence who you are.

It sounds obvious, but so often we think we are impervious to outside influence, that we’re living our own lives in a bubble. The human experience is a social one.

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Overcome Holiday Stress and Blues WITH ESSENTIAL OILS

alancing the myriad parties, shopping, baking, social gatherings, demanding guests, and company meetings with an already jampacked schedule can be intimidating and stressful for families during the holiday season. It’s no wonder that 42 percent of Americans consider the holiday season to be stressful rather than joyous, according to a December 2012 Rasmussen Reports survey. You don’t have to be a Grinch, however, when you are armed with nature’s stress-busters: essential oils.

In turn, these receptors send signals to the limbic system (responsible for memory and emotions) and the neo cortex (influential in higher thinking and emotions) of your brain, resulting in dramatic physiological changes. This process triggers a cascade of psychophysiological events that can positively impact your mood.

STRESS TAKES A TOLL It is well known that what affects the mind also affects the body, and too much stress can take a tremendous toll on your overall well-being, strain relationships, or result in holiday blues. The resulting biochemical imbalance caused by too much stress makes you more susceptible to illness, leaving you sidelined instead of able to spend quality time with friends and family during the holidays.

Cedarwood contains cedrol, a sesquiterpene that is able to cross the blood-brain barrier. A 2007 study published in the Journal of Physiological Anthropology reported that cedrol produced a relaxing effect by influencing the autonomic nervous system—the system that controls involuntary actions such as heart rate, digestion, and respiratory rate.

Happily, Mother Nature has provided aromatic compounds distilled or pressed from plants in pure, authentic essential oils that excel in balancing emotions and managing the negative effects of stress. Indeed, no remedy is so perfectly suited to immediately influence unbalanced emotions as essential oils. WHAT DO ESSENTIAL OILS DO? The aroma of essential oils stimulates the olfactory receptors in your nose, creating a positive, powerful sensation.

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RECOMMENDED OILS Two of the most beneficial essential oils for managing stress and balancing emotions are Cedarwood and Lavender.

Both animal and clinical studies suggest that Lavender not only relaxes the mind and body but also aids a normal stress response. Studies suggest that even infants, who are not generally susceptible to a placebo response, experience the calming effects of Lavender. A small study including 30 healthy students published in the October 2008 edition of Archives of Oral Biology found that inhaling Lavender for only 10 minutes reduced stress markers,

including cortisol. Inhaling calming essential oils, including Lavender, also reduces salivary cortisol levels according to a study published in the November 2012 edition of Evidencebased Complimentary and Alternative Medicine. A synergistic effect can be realized by combining Cedarwood and Lavender, which can be further enhanced by adding complementary relaxing oils such as citrus oils, Roman Chamomile, Vanilla, Ocotea, and Copaiba. To experience the balancing effects of essential oils, simply inhale directly from the bottle, diffuse in your room or office, or apply topically to the skin. You’ll be happy that you did, and it may make the difference between having a joyous or a stressful holiday season.

ABOUT THE AUTHOR Dr. Scott A. Johnson Young Living 1-800-371-3515 www.youngliving.com

Scott Johnson is the author of two books and over 225 articles in online publications and is an expert on health, fitness, and nutraceuticals. He has a doctorate in naturopathy, is a board certified Alternative Medical Practitioner (AMP), and is a Certified Professional Coach (CPC). One of his research focuses is the safety of neat topical and oral administration of essential oils, and he has published internationally on the subject.

THE HEALTHY HOLIDAY ISSUE 2018

wellness

A CALORIE RESTRICTION REMIX

WHY ALTERNATE-DAY FASTING MIGHT BECOME A COMMON WEIGHT LOSS PRACTICE

H E R F A V O R I T E T R E AT — W H E N S H E R E A L LY W A N T S TO SPOIL HERSELF—IS ONE GUMMY WORM. So goes the life of people dedicated to calorie restriction (CR) in the name of weight loss and better health. If one pound of weight lost is equal to 3,500 calories, which is nutrition scientists’ estimate,

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then losing a pound a week requires cutting 500 calories per day from our diet, which is about a quarter of our total daily calories. It would be much easier if we could just cut the calories every other day and eat like we want the other days. But that probably wouldn’t work, right? Surprise! It’s called Alternate Day Fasting (ADF) and research so far says it does work.

In an ADF diet, you eat about 25 percent of your normal calories on your diet days. For women that is about 500 and for men 600, which is about enough for a small meal. The other days, you eat like you aren’t on a diet. Krista Varady, PhD, from the Department of Kinesiology and Nutrition at the University of Illinois says it works—and she’s doing the research to back it up.

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Currently, Varady is in the middle of a three-year study comparing people on regular calorie restriction diets versus people on ADF diets. “Preliminary data show that people using ADF have actually lost more weight than people who are using plain calorie restriction,” she said. Furthermore, the ADF diet, just like a regular calorie restriction diet, has positive cardiovascular effects. In fact, in Varady’s preliminary results, both groups had similar lowered blood cholesterol levels despite their different approaches. This is the first study directly comparing the two types of diets in humans, according to Varady, who said that ADF diet probably works because intermittent deprivation is easier than long-term deprivation of calories. Diets of daily calorie restriction, though generally effective, are essentially diets of denial. The prospect of continually denying ourselves calories isn’t a happy one, but many practitioners say they are glad to have complete control of appetite, and boast excellent health. Some scientists even think that calorie restriction may extend lifespan, a theory that is heavily debated. For many people, however, maintaining a diet where one gummy worm counts as a “treat” is laughable, because it would be so difficult. Cutting a quarter of our calories every day is admittedly a tall order.

For those who consider ADF diet too intense, there is the 5:2 plan, where a person eats normally five days of the week, and eats 25 percent of normal calories for two days per week. This approach needs more study before it can be considered effective.

Starting and staying with diets is a national challenge. One Gallup poll found that well over 50 percent of Americans would like to lose weight, but only 27 percent are seriously trying. For people who do diet, Louisiana State University Biomedical researcher Catherine Champagne, PhD, told webmd.com that most people last about six months, though the level of strictness matters. “When diet plans differ immensely from previous eating patterns, restrict favorite foods or entire food groups, dieting usually lasts for a much shorter time," she says.

If cutting 500 calories every day falls into the category of differing “immensely” from your diet, it might be hard to keep up. This is why and ADF diet is so attractive, because it allows “normal” days.

Fasting can be taken to the extreme, which is unhealthy. Fasting every other day is a more balanced approach, but still should be done under expert supervision. Healthy eating will never go out the window, and the ADF diet isn’t an exception.

Granted, those days of only 500-600 calories are tough. It isn’t much food, but there’s always tomorrow, when you can eat what you want.

If people are worried that calorie restriction will result in less muscle mass, they may be right. For this reason, people over 65 shouldn’t drop their calorie levels, according to Varady. For obese people, however, calorie restriction will probably do no harm.

The ADF diet sounds like a fad diet and some weight-loss experts worry about fasting as a weight-loss tool. Fasting, by itself, isn’t an especially good weight-loss plan, according to many nutrition professionals. Fasting for a day or two is generally fine unless you already have an unhealthy diet, liver problems, kidney problems, immune system problems or are on medication, New Jersey weight loss author Joel Fuhrman, MD, told webmd.com. He also said that fasting slows down metabolic rate, which goes contrary to weight loss. Extended fasts with “cleanses” can be especially dangerous, and have little evidence of improving health. Madelyn Fernstrom, PhD, director of the University of Pittsburgh Medical Center’s Weight Loss Management Center told webmd.com that she worries people focused on fasting are distracted from “the real message of how to lose weight,” which involves eating and sleeping better along with more exercise.

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“It’s amazing how strong obese people are,” Varady said. “They’ve been carrying around all this weight that others aren’t.” As obese people limit calories, they may lose some muscle mass, along with fat. But when we lose a pound of weight, it is about 75 percent fat and only 25 percent muscle, Varady said. Furthermore, the obese will no longer need all the muscle mass they did before, because they aren’t carrying around as much weight. Remember that women should never drop their calories consistently below 1200 per day, and men should never go below 1500 per day for extended amounts of time. Eating fewer calories than this can deprive a person of important nutrients, affecting important systems in the body, even leading to malnutrition if continued for long periods of time. An ADF diet can help prevent these bad habits, since on their “off” days, people get their full calorie needs.

During a fast day, one might assume that dieters plan to gorge on food the following day, thus canceling any positive effects from eating fewer calories. But it turns out that this doesn’t happen, according to Varady’s studies, which showed people ate between 100-125 percent of their normal calories on non-fast days. She thinks shrunken stomachs from fast days may help. The Alternate Day Fasting approach to dieting may erase the need for constant deprivation, making weight loss easier and less painful. So go ahead, have two gummy worms today, just don’t eat any tomorrow.

Bio:

Dr.Varady, the world’s leading researcher on using alternate-day fasting for weight loss and weight maintenance, wrote a book that will be published this year, for those interested in learning more. Called The Every Other Day Diet, the book outlines the science-proven techniques for weight loss that Dr.Varady has developed, along with strategies, tips and tools that you’ll need for the Every-Other-Day Diet. The book also includes 80 quick and delicious recipes for Diet Day.

THE HEALTHY HOLIDAY ISSUE 2018

Nutrition IN THE LOOP

WARRIOR OR WEAKLING?

Spring weekends bring out the athlete in all of us. But does Monday morning find you the weekend weakling? Weekend workouts are good for your health and enjoyment — when you do them wisely. But if you find yourself spending all week making up for the weekend, maybe you need some nutritional and physical training.

EGG-CELLANT CHOLESTEROL

Eggs have been known for containing high amounts of cholesterol, but some new research on that topic should make you egg-cited. According to he U.S. Department of Agriculture, a large egg today only has 185 milligrams of cholesterol, down from the 215 milligrams an egg contained 10 years ago. An egg today also has 41 international units of vitamin D, much higher than the 25 international units measured years ago. Researchers believe the changes are probably due to changes in the hen’s diets or the way they are bred. Eggs have gotten healthier all around, so enjoy your omelet guilt free. Source: U.S. Dept. of Agriculture

fifty

GRAMS OF SUGAR IN THE AVERAGE 16-OZ ENERGY DRINK OR SWEETENED TEA. THAT’S OVER THREE TABLESPOONS. A 12-OZ CAN OF SODA CONTAINS 35 GRAMS.

Source: webmd.com

HYPERACTIVE FOOD COLORING

TAKE NOTE OF

Food Focus

Have a hyperactive child? Artificial food coloring may be to blame. Several studies have shown that food coloring has a connection to hyperactivity in children. The results are enough to raise concern since food coloring is used in a variety of foods in order to make them appear more appetizing. However, because of the many studies that show no connection, the FDA voted down the proposal to have food coloring warnings listed on some foods. Source: fda.gov ONE WORD SOLUTION

FOR MORE ENERGY

FOR MORE FLUIDS

Load up on low-fat, high carbohydrate foods — about 60 percent of your calories — to keep you moving.

Stay hydrated before and after your workouts with these tips:

• Non-fat yogurt • cereal, fruit and milk • pasta or soup with a whole-grain bagel • whole-grain muffins and skim milk

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• 2 HOURS BEFORE: Drink 2 cups of fluid • 10–15 MINS. BEFORE: Drink 2.5 cups of fluid • EVERY 15 MINS. AFTER: Drink .5 cups of fluid

Fat-free Fat free doesn’t equal calorie free. The term means that in a set portion, the amount of fat is so low, you don’t have to worry about it. However, this doesn’t include any requirements for calories. A food that is fat free could still contain carbohydrates or protein, making it a source of calories.

Dinner entertainment — music, TV, even conversations — could all bring unhealthy distractions. According to research, distractions during meals may lead you to eat more than you usually would. One study found that women who listened to a story while eating ate a significantly higher amount of calories than when they were focused on eating. So to limit your caloric intake, put down the remote control, take a seat at the dinner table for a change and enjoy a peaceful meal.

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Expiration Date

CONFUSION 90% of American waste billions of pounds of food because of confusing expiration date system, a new report says.

ow many times have you looked at the expiration date on a gallon of milk, realized it’s a few days past the date, given it a good sniff and then thrown it out because you just can’t be sure? We’ve all been there and for good reason. No one wants to get food poisoning from his or her morning bowl of corn flakes even though the milk didn’t smell that bad. As it turns out, we might all be guilty of wasting huge amounts of food because of a simple misunderstanding—“use by” and “sell by” dates don’t necessarily mean the food is bad. They are meant to simply indicate when the food is at its peak freshness. Some of this confusion stems from a lack of regulation for food manufacturers. In fact, there is no national regulation on “use by” or “sell by” dates because it was never an issue of public health. Food dating emerged in the 1970’s because consumers wanted to know more about their food, as a larger portion of purchased foods were not being produced locally anymore. The dates were printed on foods solely as an indication of freshness and not an indication that foods would be inedible or dangerous after the “use by” date. Herein lies the confusion. Most of us are under the impression that “use by” and “sell by” dates indicate whether foods are safe to consume or not. The reality is that these dates were never linked to an increased risk of food poisoning or foodborne illness.

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Moreover, this confusion leads many of us to throw away foods that are still safe to eat. According to a report from the National Resources Defense Council and the Harvard Food Law and Policy Council, U.S. consumers and businesses are needlessly trashing billions of pounds of food every year as a result of the confusion surrounding expiry dates. The report cited a survey conducted by The Food Marketing Institute that stated, “nine out of ten Americans throw out food because of this misunderstanding. For an average family of four, this could mean hundreds of dollars’ worth of edible and safe food is thrown away every year.” All told, the amount of food thrown away each year represents 40 percent of the U.S. food supply. The NRDC’s report calls for a standardization in labeling practices among food manufacturers in order to demystify the meaning of confusing tags that, according to the report, lead to billions of pounds of wasted food every year. It also provides consumer advice regarding specific items such as eggs and milk, and even a helpful chart on how to make better use of the space in your refrigerator to keep foods fresh, longer. nrdc.org/food/expiration-dates.asp nrdc.org/food/files/dating-game-infographic.pdf

nutrition

EXPIRED?

THE AMOUNT OF FOOD THROWN AWAY EACH YEAR REPRESENTS 40 PERCENT OF THE U.S. FOOD SUPPLY

THE HEALTHY HOLIDAY ISSUE 2018

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THE HEALTHY HOLIDAY ISSUE 2018

>> Advisor Surgery

The jeans fit! This is an essay written by one of my patients. She was so struck by her experience she turned to social media and posted this essay on her facebook page and ours. She was nervous about what people would think but was also so excited she couldn’t hold back. She got so many supportive comments that we thought we would share this woman’s experience with our readers in Healthy Magazine. “Getting a tummy tuck changed my life. Before you decide I am a shallow person that is too lazy to loose inches and get fit the more "natural way" let me tell you my story. I found out I was diabetic just before getting pregnant with my first child and was warned by doctors weight could become an issue. But being a size 7/8 pant, I thought weight would never be a problem for me. It hadn't been all my life. Tragically, I put on exactly 97 lbs with my first baby. Breastfeeding helped take some baby weight off, but I never got rid of my stomach. My abdomen was so stretched out that it even had a split down the center (you know what I am talking about). I was left with sagging, wrinkly skin. I had 2 choices, keep the muffin top so that my skin looked suppler or lose the weight and have a wrinkled old man on my stomach. What was the point of exercising when those were my options? It has been 7 weeks since my surgery and I decided to be brave enough to buy a pair of jeans. I haven't bought a pair of jean in about 8 years. Why? Because jeans make muffin tops even worse and to hide my muffin top I needed a larger pant size which made everything look wrong. Swimsuits

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and jeans are brutal on the self-esteem. I swallowed hard, walked into the store, and decided to give it a shot. I grabbed the first pair of jeans in my size (11/12) and headed for a dressing room. When I put on the jeans they fit like a glove and I couldn't believe that my very first pair of jeans looked amazing. The saleswoman said they looked perfect on me and asked if I would like to try them in a different color. She came back carrying a size7/8! Politely I said, “These won’t fit, although it would be awesome if they did.” She laughed and said, “They DO fit. You’re wearing a 7/8 now!” My heart fluttered like I was in a dream and hoped I would never wake up. I stood, stunned. Could this be true? After a decade, is a 7/8 a reality for me? Sometimes we just give up on the dream, you know? I tried on 5 more pair of pants just to reaffirm that the saleswoman wasn't a liar or this wasn’t all a mistake. (Wouldn't you?) The funny thing about surgical weight loss is that you literally have to catch up mentally to your new size. So the miracle of it all is that I look as amazing as I feel, and I am not imprisoned by low self-esteem. If you are suffering like I was, if you just want to recognize yourself in the mirror again or feel comfortable in your own skin, consider NuVista Plastic Surgery. Their staff is warm and understanding and Dr. Petersen has a gift of healing. Thank you Dr. Petersen for giving me my life back in so many, many ways!!!” -Rachel https://www.facebook.com/rachelspricematch

ABOUT THE AUTHOR Dr. Dayne Petersen NuVista Plastic Surgery nuvistaplasticsurgery.com

Dr. Petersen recently moved his practice after spending several years on the teaching faculty of the University of Oklahoma. To learn more about Dr. Petersen and breast oasis, the non-profit he supports, visit his website www.nuvistaplasticsurgery.com.

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>> Advisor Women's Health

THE OB/GYN

Top 5 List

REFORMING OBSTETRICS AND GYNECOLOGY TO REDUCE RISKS AND IMPROVE CARE In 2011 the American Board of Internal Medicine and Consumer Reports started an initiative entitled "Choosing Wisely." It grew out of an article published by Dr. Howard Brody called "Medicine's Ethical Responsibility for Healthcare Reform - The Top Five List." He suggested that each medical specialty carefully evaluate the top 5 areas of reform in their particular specialty. Over 25 medical specialties have now joined in the campaign. I want to focus on the American College of Obstetrics and Gynecology’s (ACOG) top 5 areas that needed reform. 1. The first and most widely published reform is shared by the ACOG, The American Academy of Family Physicians and The American Academy of Pediatricians. It is entitled the "Strong Start" program. It states that "Non-medically indicated deliveries should not be performed prior to 39 weeks of gestation." This statement is also strongly supported by The American College of Nurse Midwifery, The American Hospital Association, and the March of Dimes. In essence, babies should not be induced or delivered unnecessarily prior to 39 weeks unless absolutely medically necessary for the welfare of the infant or mother. This statement arose out of another very comprehensive study also published in the New England Journal of Medicine by Dr. Alan Tita that very clearly demonstrated a significant detriment to infants born before 39 weeks compared to those born after 39 weeks of gestation. By far the greatest risk to the unborn child is prematurity. With the advances in neonatal care over the past decades, some physicians became somewhat cavalier in inducing babies at earlier and earlier gestation. In 2012, a letter was sent to all 3100 obstetric hospitals in the USA stating that there needed to be a "hard stop to all non-medically indicated elective deliveries before 39 weeks gestation." This does not include those instances where there is a true need to deliver the baby early for infant or maternal indications. Some possible indications for early delivery would include things like pre-eclampsia, poorly controlled diabetes, severe growth restriction, poorly controlled hypertension, or placental abruption. However, these

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indications need to be clearly delineated in the medical record. 2. The second area of reform that ACOG chose to target was that "doctors should not induce a woman between 39 weeks and 41 weeks of gestation unless the cervix was favorable." Way back in 1964, Dr. Bishop introduced what is now called the "Bishop Score." It was meant to determine the likelihood of a vaginal delivery if a woman with previous children were to be induced. If a woman had a Bishop Score of 9 or greater, then the chance of a successful vaginal delivery was the same as if she went into labor on her own. This only applied to multiparous women with at least one prior normal delivery. Therefore, if a multiparous woman has a Bishop Score of 9 or greater, then and only then is it safe to deliver her at 39 weeks or beyond with an elective induction. This does not apply to women who have not had a baby previously. In fact, in a study recently published by the Oregon University and Health Science Center, the risk of a cesarean section increased 13 fold if a first time mother was induced with an "unripe cervix." By adhering to the policy of only inducing multiparous women with a ripe cervix at or beyond 39 weeks, we can help reduce the horrible cesarean rate in the USA. I personally won't induce a first time mother till 41 weeks, unless medically indicated to try to substantially reduce their risk of a c-section. 3. The last 3 initiatives actually focus on reduced rather than increased screening. The 3rd on the Choosing Wisely list is to decrease the frequency of pap smears. In the past, yearly pap smears were recommended for all women over age 18. This is now changed to not start to do pap smears till age 21, and then only every 3 years till age 30. After age 30, co-testing with pap and HPV tests only every 5 years. This does not obviate the need for your annual exam however. You still ought to see your OB/GYN every year for things like breast cancer screening, appropriate blood tests, vaccinations, and for a complete physical exam. 4. The fourth also focuses on pap testing. It states that “women with mild cervical dysplasia need not be treated." In other words,

we were too aggressive in treating women with pre-cancerous lesions of the cervix. In treating women with LEEP procedures we were inadvertently causing premature deliveries by removing too much of the cervix in treating disease that was very unlikley to progress to cancer. 5. The last issue to be addressed was to "NOT SCREEN ASYMPTOMATIC WOMEN AT ANY AGE FOR OVARIAN CANCER." This seems wrong, but in reality it is very good. Unfortunately we currently do not have a good screening modality for ovarian cancer. It would take about 10,000 asymptomatic women to be screened to find one ovarian cancer. What would happen would be very many unnecessary surgeries and many needless deaths if we were to try to screen every woman for ovarian cancer. Even now, when 21 women are suspected to have ovarian cancer with an ovarian mass, only one will actually have ovarian cancer. In summary, by not being induced prior to 39 weeks, if you've had a prior baby, or 41 weeks if you’re having your first one, we can decrease fetal and maternal risks. Also by decreasing the frequency of pap smears and not screening for ovarian cancer, we can actually improve the quality of care for women of all ages. For other advice on women's healthcare, contact Dr. Mark T. Saunders at 801-6921429 or visit us at DRSAUNDERSOBGYN. com For more information on The Choosing Wisely campaign, go to acog.org.

ABOUT THE AUTHOR Mark Saunders, MD

Obstetrics & Gynecology Personal Care drsaundersobgyn.com Dr. Saunders is a well-respected board certified obstetrician and gynecologist that has been practicing for over 16 years.

THE HEALTHY HOLIDAY ISSUE 2018

FINGERS WON’T

STR AIGHTEN? WHAT IS IT?

Dupuytren’s (doo-puh-trens) Contracture is a condition involving the palm and fingers. Connective tissue (aplmar fascia) just under the skin in the palm begins to thicken and shorten, which causes development of contracted cords and nodules. The fingers then curl down toward the palm. The ring and little finger are most commonly affected.

ACCEPTING

· No surgery NEW PATIENTS · No scars · No pain · No rehab · Recover in days instead of months · As little as 1/20 the cost of surgery · Immediate use of hand/fingers · Back to work quickly

NO SURGERY!

BEFORE

Now there is a simple, quick non-surgical medical treatment available in the Salt Lake market by Doctor David Kline. This technique was developed in Paris by Doctor J. L. Lermusiaux in the early 1950’s. Dr. Kline had his own hand treated by Dr. Lermusiaux, then studied the procedure and brought the technique to the U.S. in 2002.

AFTER

Under local anesthetic, Dr. Kline uses a small hypodermic needle to divide and release the contracting bands in the diseased areas of the palm and fingers. THE EFFECTIVENESS IS OUTSTANDING! Patients are able to open their hands immediately.

COMING SOON TO SALT LAKE CITY! 430 N 400 W

SALT LAKE CITY

801-364-0880

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H a i r Re s t o r a t i o n C e n t e r o f U t a h .c o m 2104 FORT UNION BLVD, SLC, UT

THE HEALTHY HOLIDAY ISSUE 2018

The Men’s Health Center in Salt Lake City offers a health care concept engineered exclusively for men by medical experts. Managing your health is our mission and we take pride in offering better service at a doctor’s office. Our clients want to use their time at the doctor’s office effectively, prevent health problems before they start and avoid the pitfalls of “managed” care. Our approach is to personalize your health service and positively impact your health. Early detection and early treatment of health problems are the cornerstones of our strategy. The MHC medical team has years of experience treating common conditions such as high blood pressure, diabetes, impotence, and high cholesterol. We also offer weight control programs, hormone replacement and treatment of sleep problems/ psychological issues. We aggressively screen for heart disease and cancer.

We have one clear goal: to identify and treat your personal health risks. And our medical service is tailored especially to men. Come experience the MHC difference. We believe there is no more important investment than your health! 80 HEALTHY MAGAZINE 2018

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MENSHEALTHCENTER.COM 1002 E. SOUTH TEMPLE SUITE 202 SALT LAKE CITY, UT 84102 PHONE: (801) 521-2102 Facebook.com/HealthyMag

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THE HEALTHY HOLIDAY ISSUE 2018

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